TN 


PARTMENT  OF  THE  INTERIOR 

FRANKLIN  K.  LANE,  SECRETARY 

BUREAU  OF  MINES 

VAN.  H.  MANNING,  DIRECTOR 


ADVANCED 
FIRST-AID  INSTRUCTIONS  FOR  MINERS 

A  REPORT  ON  STANDARDIZATION 


BY 

A  COMMITTEE  OF  SURGEONS: 

G,  H,  HALBERSTADT,  A.  F,  KNOEFEL,  W.  A.  LYNOTT 

W,  S.  ROUNTREE,  AND  M,  J.  SHIELDS 


WASHINGTON 
GOVERNMENT  PRINTING  OF 
1917 


DEPARTMENT,  QF  't^E  jIsf 

FRANKLIN  ;K.  I(Atr$,  S^aECART •;      *. 

t),^,  BUREA'C  O'F  MINES 

VAN.  H.  MANNING,  DIRECTOR 

ADVANCED 
FIRST-AID  INSTRUCTIONS  FOR  MINERS 

A  REPORT  ON  STANDARDIZATION 


BY 

A  COMMITTEE  OF  SURGEONS: 

G.  H.  HALBERSTADT,  A.  F.  KNOEFEL,  W.  A.  LYNOTT 

W.  S.  ROUNTREE,  AND  M.  J.  SHIELDS 


WASHINGTON 

GOVERNMENT  PRINTING  OFFICE 
1917 


The  Bureau  of  Mines,  in  carrying  out  one  of  the  provisions 
of  its  organic  act — to  disseminate  information  concerning  in- 
vestigations made — prints  a  limited  free  edition  of  each  of  its 
publications. 

When  this  edition  is  exhausted  copies  may  be  obtained  at 
cost  price  only  through  the  Superintendent  of  Documents/  Gov- 
ernment Printing  Office,  Washington,  D.  C. 

The  Superintendent  of  Documents  is  not  an  official  of  the 
Bureau  of  Mines.  His  is  an  entirely  separate  office  and  he 
should  be  addressed : 

SUPERINTENDENT  OF  DOCUMENTS, 

Government  Printing  Office, 

Washington,  D.  C. 

The  general  law  under  which  publications  are  distributed 
prohibits  the  giving  of  more  than  one  copy  of  a  publication  to 
one  person.  The  price  of  this  publication  is  20  cents. 

To  meet  a  demand  for  this  handbook  bound  in  substan- 
tial form,  the  Superintendent  of  Documents  has  issued  an 
edition  in  stiff  covers  bound  in  red  buckram.  The  price  of 
a  bound  copy  is  35  cents. 

First  edition.     Uay,  1917. 


CONTENTS. 

Page. 

Preface  by  VAN  H.  MANNING XT 

Introduction 3 

First-aid   organization o 

First-aid   equipment 7 

Surface  first-aid  dressing  station 7 

Contents  of  first-aid  cabinet 7 

Underground  dressing  stations 10 

Surface  hospital  room 10 

Suggestions 11 

Caring  for  the  injured 12 

General  directions 13 

What  a  first-aid  man  should  do 14 

Don'ts 15 

Anatomy  of  the  human  body i_  17 

Skeleton 17 

Joints 19 

Muscles 19 

Tendons____ 20 

Skin 20 

Blood  supply 20 

Heart 21 

Blood  vessels 21 

Respiration 22 

Lungs 23 


ii  CONTENTS. 

Anatomy  of  the  human  body — Continued.  Page. 

Digestive  system 24 

Excretory   system 24 

Nervous  system 24 

Epilepsy 25 

Shock 26 

Electric    shock 28 

Treatment  for  electric  shock 29 

Suffocation   or   asphyxiation 29 

Gas  poisoning 30 

Carbon  monoxide  or  white  damp 31 

Drowning .. 33 

Artificial  respiration  by  the  Schaefer  or  prone  method 3.3 

Use  of  resuscitation  devices 36 

Dressings 38 

Bandages 38 

Triangular  bandage 38 

Cravat 38 

Bandage  compress ,    39 

Arm    sling 39 

Cravat   sling 39 

Tourniquet 40 

Splints 41 

Need  of  careful  bandaging 42 

Reef   knot 42 

Hemorrhage  or  bleeding 43 

Pressure  points  to  stop  bleeding 45 

Open   wounds 45 

Precautions  against  infection  of  wounds 46 

Internal  hemorrhage 46 


CONTENTS.  iii 

Page. 

Dressings  for  wounds  and  bleeding 47 

Wound  and  bleeding  of  scalp 47 

Wound  and  bleeding  of  temple 47 

Wound  and  bleeding  of  forehead 48 

Wound  and  bleeding  of  eye 49 

Wound  and  bleeding  of  nose 51 

Wound  and  bleeding  of  face  or  chin 52 

Wound  and  bleeding  of  neck  or  throat 52 

Wound  and  bleeding  of  ear 53 

Wound  and  bleeding  of  shoulder 53 

Wound  and  bleeding  of  armpit 54 

Arm  torn  from  body 54 

Wound  and  bleeding  of  arm 55 

Wound  and  bleeding  of  elbow 56 

Wound  and  bleeding  of  forearm  or  wrist 57 

Wound  and  bleeding  of  back  of  hand 57 

Wound  and  bleeding  of  palm  of  hand ^  58 

Wound  and  bleeding  of  finger 60 

Wound  and  bleeding  of  side  of  chest 60 

Wound  and  bleeding  of  abdomen 61 

Wound  and  bleeding  between  shoulders 61 

Wound  and  bleeding  of  back 61 

Wound  and  bleeding  of  groin 63 

Wound  and  bleeding  of  hip 64 

Wound  and  bleeding  of  thigh 64 

Wound  and  bleeding  of  knee 65 

Bleeding  from  varicose  veins  in  the  leg 66 

Wound  and  bleeding  of  leg 66 

Wound  and  bleeding  of  ankle  or  heel 67 


iv  CONTENTS. 

Dressings  for  wounds  and  bleeding — Continued.  rage. 

Wound  and  bleeding  of  foot 68 

Wound  and  bleeding  of  foot  or  ankle 68 

Wound  and  bleeding  of  toe - 69 

Foreign  bodies  in  ear 69 

Foreign  bodies  in  nose 70 

Foreign  bodies  in  windpipe  or  throat TO 

Foreign  bodies  in  stomach 71 

Bruises 71 

Strains 72 

Sprains 72 

Dislocations 73 

Dislocation  of  lower  jaw 73 

Dislocation  of  shoulder 74 

Dislocation  of  elbow 76 

Dislocation  of  finger 76 

Dislocation  of  knee  or  kneecap 76 

Dislocation  of  hip 77 

Fractures 78 

Fracture  of  skull 79 

Fracture  of  nose SO 

Fracture  of  upper  jaw  or  cheek  bone 80 

Fracture  of  lower  jaw SO 

Fracture  of  collar  bone 81 

Fracture  of  shoulder  blade S3 

Fracture  of  arm S3 

Fracture  of  elbow 84 

Fracture  of  forearm 85 

Fracture  of  wrist 87 

Fracture  of  bones  of  hand 87 


CONTENTS,  v 

Fractures — Continued.  Page. 

Fracture  of  finger 88 

Fracture  of  rib 88 

Fracture  of  spine 89 

Fracture  of  pelvis  or  haunch  bone 91 

Fracture  of  thigh 93 

Fracture  of  kneecap 95 

Fracture  of  leg 96 

Fracture  of  ankle 96 

Fracture  of  foot  or  toe 97 

Placing  bandages  under  splints 97 

Compound  fractures 98 

Burns  or  scalds 98 

Burns  of  back 99 

Burns  of  chest 100 

Burns  of  face,  head,  or  neck 100 

Burns  of  arms 101 

Burns  of  hands 101 

Rupture •___  101 

Poisons 103 

Corrosive  poisons 103 

Irritant  poisons 104 

Treatment 105 

Nerve  poisons 105 

Treatment   for   poisons  that   cause  unconscious- 
ness   . 105 

Treatment  for  poisons  that  cause  convulsions 105 

Alcoholic  poisoning  and  apoplexy 106 

Treatment  for  alcoholic  poisoning 106 

Treatment  for  apoplexy 106 


vi  CONTENTS. 

Poisons — Continued.  Page. 

Carbolic  acid  poisoning 107 

Treatment 107 

Transportation  of  injured 108 

One-man  carry 108 

Two-man  carry 109 

How  one  person  may  remove  an  injured  or  uncon- 
scious person  in  low  coal  or  a  thin  vein 110 

Stretchers 111 

Types  of  stretchers 111 

Stretcher  drill 113 

Sunstroke 124 

Heat  exhaustion 124 

Frost  bites  and  freezing 125 

Snake  bites 125 

Counterirritants 120 

Mustard  poultice 126 

Mustard  plaster 12G 

Turpentine  stupe 127 

Material  for  advanced  first-aid  students 128 

Digestive  system 128 

Mouth 128 

Tongue 129 

Teeth 129 

Esophagus 130 

Stomach 130 

Small  intestine 131 

Large  intestine 131 

Liver 132 

Gall  bladder 132 

Pancreas 132 

Process  of  digestion 132 


ILLUSTRATIONS.           ,  vii 

Counterirritants — Continued.  Page. 

Excretory  system 135 

Skin 135 

Kidneys 136 

Medication 137 

Medication  by  mouth 138 

Rectal  medication 139 

Publications  of  especial  interest  to  miners 141 

Index—.  145 


ILLUSTEATIOXS. 


FIGURE     1.  First-aid  cabinet  and  contents 8 

2.  The  human  skeleton ^___  1.8 

3.  The  surface  muscles  of  the  body 19 

4.  The  principal  arteries  and  veins  of  the  body 20 

5.  Relation  of  principal  arteries  to  the  bones 22 

6.  Schaefer   (or  prone)   method  of  artificial  res- 

piration— Inspiration 34 

7.  Schaefer   (or  prone)   method  of  artificial  res- 

piration— Expiration 35 

8.  Tourniquet  applied  to  the  arm 40 

9.  Tourniquet  applied  to  the  thigh 41 

10.  Reef  knot,  tightened  and  loosened 43 

11.  Bandage  for  top  of  head  for  bleeding,  wound, 

or  fractured  skull__.                 47 


viii  ILLUSTRATIONS. 

Page. 

FIGURE  12.  Dressing  for  wound  of  temple 48 

13.  Dressing  for  bleeding  and  wound  of  forehead-  49 

14.  Dressing  for  wound  and  bleeding  of  eye 50 

15.  Dressing  for  wound  or  fracture  of  nose 51 

16.  Dressing  for  wound  or  bleeding  of  chin  or  face_  52 

17.  Dressing  for  wound  of  ear 53 

18.  Dressing  for  wound  and  bleeding  of  shoulder-  54 

19.  Dressing  for  wound  of  armpit 55 

20.  Dressings  for  wounds  of  arm  and  forearm 5G 

21.  Dressings  for  wounds  of  elbow  and  wrist 55 

22.  Dressing  for  wound  of  back  of  hand 58 

23.  Dressing  for  wound  of  palm  of  hand 59 

24.  Dressing  for  wound  of  finger 59 

25.  Dressing  for  wound  of  side  of  chest GO 

26.  Dressing  for  wound  of  abdomen Gl 

27.  Dressing  for  wound  between  shoulders G2 

28.  Dressing  for  wound  of  lower  part  of  back (>o 

29.  Dressing  for  wound  of  groin Gi 

30.  Dressing  for  wound  of  hip G5 

31.  Dressing  for  wound  of  thigh G5 

32.  Dressing  for  wound  of  knee GG 

33.  Dressing  for  wound  of  leg G7 

34.  Dressing  for  wound  of  ankle  or  heel G8 

35.  Dressing  for  wound  of  foot  or  toe G8 

36.  Dressing  for  wound  of  foot  or  ankle G9 

37.  Dressing  for  dislocation  or  fracture  of  lower 

jaw 74 

38.  Dressing  for  dislocation  of  shoulder 75 

39.  Dressing  for  dislocation  of  hip 78 


ILLUSTRATIONS.  ix 

Page. 

FIGURE  40.  Dressing  for  fracture  of  collar  bone,  back  view_  81 

41.  Dressing  for  fracture  of  collar  bone,   front 

view 82 

42.  Dressing  for  fracture  of  arm 84 

43.  Dressing  for  fracture  of  elbow 85 

44.  Dressing  for  fracture  of  forearm 86 

45.  Dressing  for  fracture  of  hand 87 

46.  Dressing  for  broken  ribs 88 

47.  Dressing  for  broken  back,  front  view 90 

48.  Dressing  for  broken  back,  rear  view 91 

49.  Dressing    for    fracture   of   pelvis    or    haunch 

bones 92 

50.  Dressing  for  fracture  of  thigh 94 

51.  Dressing  for  fracture  of  kneecap 95 

52.  Dressing  for  fracture  of  leg  or  ankle 96 

53.  Dressing  for  fracture  of  foot  or  toes 97 

54.  Dressing  for  burns  of  back 99 

55.  Dressing  for  burns  of  face,  head,  and  neck_ 100 

56.  One-man  carry 109 

57.  Two-man  carry 110 

58.  "  Fall  in  line — Count  one,  two,  three,  four  " 113 

59.  Crew  in  line,  No.  3  having  obtained  stretcher.  114 

60.  "  Carry   stretcher — March  " 115 

61.  Placing  patient  on  stretcher 116 

62.  Lifting  patient 117 

63.  Prepared  to  carry  patient 119 

64.  Stretcher  of  Army  type  and  first-aid  splints 121 

65.  Diagram  of  stretcher  drill 123 


PREFACE. 

One  of  the  most  important  inquiries  that  Congress  has  au- 
thorized the  Bureau  of  Mines  to  conduct  relates  to  health  condi- 
tions among  those  engaged  in  the  mineral  industries.  Investiga- 
tions made  early  with  a  view  to  bettering  these  conditions 
demonstrated  the  need  of  prompt  care  of  injured  miners,  as. 
under  the  difficulties  inherent  to  mining,  wounds  seemingly  un- 
important, if  not  treated  promptly,  may  become  infected  and 
possibly  cause  permanent  crippling  or  even  death  of  the  miner. 
In  the  past,  many  seriously  injured  miners  have  been  brought 
out  of  mines  by  fellow  workers  ignorant  of  approved  means  of 
transportation,  and  have  been  handled  in  such  a  manner  as  to 
cause  suffering  and  to  accentuate  injuries  to  such  a  degree  as  to 
bring  about  permanent  disablement.  Accordingly,  the  need  of 
general  instruction  in  first  aid  became  apparent. 

In  this  country  education  of  the  miners  in  first  aid  was  prob- 
ably first  taken  up  systematically  in  the  Pennsylvania  anthracite 
mining  district,  and  training  was  carried  on  actively  in  that 
district  by  Dr.  G.  H.  Halberstadt  and  Dr.  M.  J.  Shields,  work- 
ing with  the  cooperation  of  some  of  the  large  mine  operators. 
Subsequently  first-aid  training  was  actively  carried  on  by  Dr. 
W.  S.  Rountree  in  Alabama  and  by  Dr.  A.  F.  Knoefel  in  In- 
diana. Meantime,  a  general  campaign  in  first-aid  training 
among  industrial  workers  was  carried  on  by  the  American  Red 
Cross  Society,  but  when  the  Bureau  of  Mines  began  its  nation- 

xi 


xii  PREFACE. 

wide  campaign  of  instructing  miners  in  the  use  of  mine  rescue 
apparatus  and  in  methods  of  first  aid,  the  American  National 
Red  Cross  turned  over  that  part  of  its  industrial  training  work 
to  the  bureau,  but  continued  to  cooperate  by  furnishing  sur- 
geons as  judges  in  important  first-aid  contests  and  demonstra- 
tions. Also,  the  Red  Cross  assisted  in  determining  the  methods 
of  training  suitable  for  mining  conditions. 

It  must  be  recognized  that  the  conditions  in  and  about  the 
mines  usually  present  difficulties  not  found  in  large  industrial 
centers  where  experienced  surgeons  are  available  and  hospitals 
close  at  hand.  Many  mines  are  isolated  and,  when  an  accident 
occurs  several  miles  underground,  there  may  be  a  serious  lapse 
of  time  before  the  injured  person  can  be  brought  to  the  surface 
and  taken  to  the  hospital,  or  given  attention  by  a  surgeon  who 
may  have  to  come  a  long  distance.  Under  such  conditions  it 
has  been  frequently  demonstrated  that,  if  effective  first  aid  is 
not  given,  the  injured  person  may  die  or  become  permanently 
crippled.  This  factor  in  training  miners  has  been  recognized 
and  accounts  for  any  slight  differences  between  the  publications 
on  first-aid  issued  by  the  Red  Cross  and  those  issued  by  the 
Bureau  of  Mines. 

The  bureau  has  had  the  active  cooperation  of  the  Red  Cross 
in  the  preparation  of  these  publications,  and  in  connection  with 
the  preparation  of  his  handbook  Dr.  M.  J.  Shields  was  detailed 
by  the  Red  Cross  to  assist  in  standardizing  the  methods  pre- 
scribed for  the  bureau's  mine  rescue  corps. 

In  1913  the  bureau  issued  a  miners'  circular  giving  instruc- 
tions on  first-aid  work.  Subsequently,  when  the  need  appeared 
of  another  circular  explaining  in  the  simplest  possible  language 


PREFACE.  xiii 

the  rudiments  of  first  aid  for  the  miner,  Miners'  Circular  2£ 
was  prepared  by  Dr.  W.  A.  Lynott,  mine  surgeon,  and  D.  Har- 
rington, mining  engineer. 

Early  in  1916  it  became  manifest  that  there  was  need  of  ant 
advanced  course  in  first-aid  instruction  for  miners'  first-aid 
crews  who  had  been  thoroughly  trained  in  the  rudiments ;  also 
it  was  evident  that  the  methods  of  giving  instruction  should  be 
standardized,  inasmuch  as  contests  held  in  various  parts  of  the 
country  had  disclosed  that  miners  trained  by  different  mine 
surgeons  in  the  various  districts  had  been  given  differing  in- 
structions. Consequently,  it  was  deemed  wise  to  appoint  a 
representative  committee  to  prescribe  standard  methods.  Ac- 
cordingly, Dr.  G.  H.  Halberstadt,  of  Pennsylvania ;  Dr.  A.  P. 
Knoefel,  of  Indiana ;  Dr.  W.  S.  Rountree,  of  Alabama ;  Dr.  M.  J. 
Shields,  of  the  American  National  Red  Cross;  and  Dr.  W.  A. 
Lynott,  mine  surgeon  of  the  Bureau  of  Mines,  all  of  whom  had 
had  wide  experience  in  mine  surgery  and  in  giving  first-aid 
instruction  to  miners,  wrere  invited  to  assemble  at  the  bureau's 
Pittsburgh  experiment  station  and  formulate  in  detail  methods 
of  giving  first  aid  for  the  various  classes  of  injury  that  were 
likely  to  take  place  in  mines,  and  methods  of  resuscitation  from 
electric  shocks,  from  drowning,  and  from  suffocation  by  poison- 
ous gases  or  through  deficiency  of  oxygen.  This  handbook 
represents  the  fruits  of  their  labors.  Although  there  was  neces- 
sarily some  diversity  of  opinion  as  to  minor  details,  all  agreed 
MS  to  the  essential  features  of  the  methods  outlined  herein. 

Although  the  Bureau  of  Mines  is  authorized  by  Congress  to 
investigate  both  safety  and  health  conditions  in  the  mineral  in- 
dustries, it  has  become  evident  during  the  past  few  years  that. 


xiv  PREFACE. 

to  some  extent  the  bureau's  work  relating  to  health  conditions 
overlaps  work  of  the  Public  Health  Service.  As  the  latter 
organization  had  a  highly  trained  corps  of  specialists,  it  was 
agreed  that  inquiries  requiring  expert  opinion  on  medical,  sur- 
gical, or  sanitary  conditions  should  be  conducted  cooperatively 
by  the  assignment  to  the  Bureau  of  Mines  of  medical  officers 
from  the  Public  Health  Service,  so  that  both  bureaus  might 
receive  the  benefits  from  the  investigations  .carried  on  in  con- 
junction with  the  first-aid  training  of  the  cars  and  stations  in 
mine  rescue  operations  and  the  health  conditions  found  in  min- 
ing and  metallurgical  establishments.  This  plan  of  procedure, 
which  has  already  been  carried  out  in  the  study  of  miners' 
consumption  and  health  conditions  in  the  Joplin  zinc  district 
and  in  the  Butte,  Mont.,  copper  district,  will  be  extended  to  the 
methods  of  instruction  given  by  the  first-aid  and  rescue  corps 
of  the  bureau.  Accordingly,  this  report  was  submitted  to  and 
approved  by  the  Public  Health  Service,  some  slight  revisions 
made  being  accepted  by  the  committee. 

VAN.  H.  MANNING,  Director. 


ADVANCED  FIRST-AID  INSTRUCTIONS  FOR 
MINERS :  A  REPORT  ON  STANDARDIZA- 
TION.   

By  a  Committee  of  Surgeons  Consisting  of  G.  H. 
HALBERSTADT,  A.  F.  KNOEFEL,  W.  A.  LYNOTT, 
W.  S.  ROTJNTREE,  and  M.  J.  SHIELDS. 


INTRODUCTION. 

The  primary  work  of  the  Bureau  of  Mines,  as  authorized  by 
Congress,  is  to  investigate  safety  and  health  conditions  in  the 
mineral  industries,  with  a  view  to  making  recommendations 
for  preventing  fatalities  and  accidents. 

Investigations  made  by  the  bureau  strongly  indicate  that 
health  conditions  and  environment  are  important  factors  in 
the  occurrence  of  mine  accidents.  It  is  not  the  purpose  of  the 
bureau  to  criticize  the  work  of  physicians,  miners,  or  mining 
men,  but  to  cooperate  with  them  in  these  investigations  with  a 
view  to  ascertaining  wherein  conditions  may  be  improved.  The 
main  object  in  investigations  is  to  exchange  ideas  with  a  view 
of  gaining  important  information  as  well  as  imparting  such 
knowledge  as  the  bureau  has  obtained  elsewhere. 

The  Bureau  of  Mines  maintains  various  mine-safety  and 
mining-experiment  stations.  The  object  of  the  mine-safety 
51607°— 17 2  3 


4        ADVAtfCISD  ITRST-AID  INSTRUCTIONS  FOR  MINERS. 

stations  is  to  give  instruction,  training,  and  demonstrations  and 
to  disseminate  information  regarding  safe  and  unsafe  practices 
in  mining  and  to  do  whatever  else  can  be  done  to  aid  in  im- 
proving safety  and  health  conditions  in  mining  communities  and 
in  promoting  the  welfare  of  the  miner. 

The  principal  means  of  reaching  the  miner  and  interesting 
him  in  this  safety  work  is  through  13  mine-safety  stations,  some 
of  which  are  stationary  buildings,  and  some  of  which  are  mov- 
able cars.  Each  car  has  a  foreman  miner  to  give  training  and 
demonstrations  in  modern  safety  and  rescue  methods  and  a 
first-aid  miner  to  give  training  and  demonstrations  in  first  aid 
to  the  injured,  and  from  time  to  time  each  will  have  attached 
to  it  a  district  mining  engineer  and  a  surgeon  to  confer  with 
mine  operators,  mine  physicians,  and  others,  and  will  look  after 
the  general  problem  of  safety.  Each  station  is  in  charge  of  a 
foreman  miner,  who  gives  both  mine  rescue  and  first-aid  training. 

The  mine  safety  stations  housed  in  buildings  are  situated 
at  Pittsburgh,  Pa.,  Jellico,  Tenn.,  Birmingham,  Ala.,  McAlester, 
Okla.,  and  Seattle,  Wash.  The  stations  at  Pittsburgh,  Pa., 
Seattle,  Wash.,  and  Birmingham,  Ala.,  are  equipped  with  mine 
rescue  motor  trucks.  The  mine  rescue  cars  move  from  place 
to  place.  Headquarters  for  the  cars  are  Pittsburgh,  Pa.,  Hunt- 
ington,  W.  Vu.f  Evansville,  Ind.,  Ironwood,  Mich.,  Pittsburg, 
Kans.,  Butte,  Mont.,  Reno,  Nev.,  and  Raton,  N.  Mex. 

This  publication  is  to  be  used  as  a  text  for  guidance  of 
bureau  teachers  and  is  also  to  serve  as  a  guide  and  reference 
book  to  miners  and  others.  The  imperative  need  of  first  aid  in 
case  of  injury  or  sudden  illness  makes  it  the  duty  of  every  one 
to  be  able  to  render  proper  assistance  until  the  doctor  arrives 
on  the  scene  or  until  the  injured  person  can  be  taken  to  him. 


FIKST-AID  ORGANIZATION.  5 

The  purpose  of  this  handbook  is  to  show  the  proper  ways  of 
caring  for  injured  or  sick  persons. 

In  rendering  first  aid  all  that  is  necessary  is  to  use  common 
sense  and  to  follow  instructions.  A  first-aid  man  should  not 
attempt  work  that  should  be  done  by  a  doctor  or  surgeon,  but 
should  simply  make  the  patient  comfortable  so  that  he  may  be 
taken  to  his  home  or  to  a  hospital  and  be  less  liable  to  suffer 
from  a  wound  becoming  infected  or  a  broken  bone  pushing 
through  the  skin.  The  first-aid  man  should  not  touch  an  open 
wound  with  his  hands  or  with  an  instrument,  but  should  place 
a  clean  bandage  compress  over  it  and  leave  further  treatment 
for  the  physician  or  surgeon. 

Accidents  are  more  common  than  they  should  be,  and  every 
man  who  studies  first  aid  will  realize  the  need  of  being  cautious 
and  careful  in  the  performance  of  his  daily  work.  One  of  the 
most  important  duties  of  a  first-aid  man  is  to  learn  to  take 
charge  of  affairs  at  the  scene  of  an  accident  as  soon  as  he  ar- 
rives and  to  give  the  necessary  orders  for  insuring  the  relief 
of  the  injured  person.  When  caring  for  an  injury,  he  should 
consider  how  it  has  happened  and  afterwards  take  steps  to  pre- 
vent a  similar  accident.  Prevention  is  better  than  cure. 

FIRST-AID   ORGANIZATION. 

The  purpose  of  a  first-aid  organization  should  be  to  instruct 
and  train  men  to  assist  those  who  may  be  injured,  sick,  or 
rendered  helpless,  to  promote  good  fellowship  among  its  mem- 
bers, to  study  causes  of  accidents  and  means  to  prevent  their 
occurrence,  to  enlist  individual  and  public  interest  in  the  social 
betterment  and  the  public  health  of  the  community,  and  to  pro- 
mote safety  first. 


6        ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

To  make  first  aid  a  success  and  to  render  it  most  efficient 
necessitates  the  interest,  cooperation,  and  unqualified  sup- 
port of  the  mine  owners,  mine  operators,  mine  surgeon,  mine 
superintendent,  foreman,  and  employees.  The  mine  owners  or 
operators  can  be  of  great  assistance  by  providing  a  convenient 
meeting  room  and  fitting  it  with  first-aid  equipment.  The 
surgeon  should -aid  by  arranging  lectures  and  acting  as  director 
and  instructor  in  first-aid  work.  The  superintendent  and  fore- 
man should  assist  by  encouraging  the  men  to  attend  the  meet- 
ings and  by  attending  and  taking  an  active  part  themselves. 

The  officers  of  the  association  should  consist  of  a  president, 
vice  president,  secretary-treasurer,  and  medical  director.  Their 
duties  are  similar  to  those  of  like  officers  in  other  associations. 

The  membership  can  be  made  up  of  active  and  associate  mem- 
bers. The  active  members  should  be  divided  into  squads  or 
teams  of  six  men,  which  include  one  captain,  one  subject,  and 
four  stretcher  bearers. 

The  election  or  appointment  of  the  captains  of  the  different 
teams  should,  if  possible,  be  so  arranged  as  to  have  them  well 
distributed  about  different  parts  of  the  mine.  The  associate 
membership  should  be  made  up  of  those  of  the  community  who 
are  interested  in  lectures  on  public  health  and  social  welfare 
and  are  willing  to  help  first-aid  work  but  do  not  wish  to  take  the 
practice  drills.  Semimonthly  meetings  should  be  held,  at  which 
lectures  should  be  given,  first-_aid  dressings  demonstrated,  and 
recent  accidents  discussed  and  means  suggested  to  prevent  their 
recurrence. 

The  following  committees  should  be  appointed :  Executive 
committee,  membership  committee,  and  social  committee,  and 
other  committees  if  necessary.  The  executive  committee  should 


FIRST-AID   EQUIPMENT.  7 

consist  of  the  president  of  the  association,  the  mine  surgeon, 
the  mine  superintendent,  and  the  captains  of  the  different  teams. ' 
The  membership  arid  social  committees  should  be  appointed  by 
the  president.  The  executive  committee  should  have  charge  of 
the  management  of  the  association  and  of  arrangements  for  con- 
tests and  competitive  drills  among  the  different  teams.  The 
membership  committee  should  encourage  their  friends  and  fellow 
workers  to  join  the  association.  The  social  committee  should 
arrange  for  entertainments  to  be  held  under  the  auspices  of  the 
association. 

FIBST-AID   EQUIPMENT. 

SURFACE  FIRST-AID  DRESSING  STATION. 
At  a  suitable  place  on  the  surface  and  near  the  mine  opening 
there  should  be  a  first-aid  dressing  station,  which  also  can  be 
used  as  a  storeroom  for  first-aid  supplies.  In  this  building 
should  be  a  stretcher,  woolen  blanket,  waterproof  blanket,  and 
splints,  all  of  which  except  the  splints  should  be  suitably  pro- 
tected from  moisture  and  air  in  a  sealed  tin  case,  or  its  equiva- 
lent. Also  there  should  be  first-aid  packets  in  germ-proof  and 
waterproof  wrappings  suitably  protected  in  sealed  metal  boxes, 
and  first-aid  cabinets. 

CONTENTS    OF    FIRST-AID    CABINET. 

Each  cabinet  (fig.  1)  should  contain: 

Twelve  sterilized  triangular  (unprinted)  bandages. 

Twelve  small  bandage  compresses,  each  1  inch  square  when 
folded  upon  itself  about  15  times,  with  muslin  tails  4  yard  long, 
the  center  being  sewed  to  compress. 

Twelve  medium-size  bandage  compresses,  each  2J  inches  square 
when  folded  upon  itself  about  18  times,  with  muslin  tails  1  yard 
long,  the  center  being  sewed  to  compress. 


ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


FIGURE  1. — First-aid  cabinet  and  contents.  1,  triangular  bandage;  2, 
large  bandage  compress  ;  3,  medium-size  bandage  compress  ;  4,  tourni- 
quet ;  5,  cravat  bandage ;  6,  metal  first-aid  packet ;  7,  scissors ;  8, 
paper  cups  ;  9,  picric  acid  gauze  ;  10,  small  bandage  compress ;  11, 
spoon ;  12,  13,  splints ;  14,  first-aid  cabinet  or  case ;  15,  aromatic 
spirits  of  ammonia. 


FIRST-AID  EQUIPMENT.  9 

Six  large  bandage  compresses,  each  3£  inches  square,  and 
folded  upon  itself  about  20  times,  with  muslin  tails  2  yards  long, 
the  center  being  sewed  to  compress. 

Six  packages  of  sterile  picric-acid  gauze,  each  containing  a 
piece  of  gauze  1  yard  square. 

Six  yucca  splints  or  similar  material. 
One  2-ounce  bottle  of  aromatic  spirits  of  ammonia. 
Six  paper  cups. 
One  teaspoon    (horn). 
One  tourniquet. 
One  pair  of  scissors. 

The  approximate  cost  (probably  higher  rather  than  lower)  of 
each  article  is  as  follows : 
Cabinet : 

Metallic    case $1.  00 

12  triangular  bandages   (plain) 1.20 

12  small  compresses .  24 

12  medium   compresses .  48 

6  large  compresses .  50 

6  picric  acid  gauze  bandages   (each  1  yard 

long,  in  hermetically  sealed  paper  carton).     2. 16 
1  two-ounce  bottle  of  aromatic  spirits  of  am- 
monia        .  10 

6   splints .35 

1  tourniquet , .  10 

1  pair  of  scissors .  10 

1   spoon .05 


Total 6.  58 


10      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

Metal  packet: 

Metal  case  (similar  to  one  used  by  American 

National  Red  Cross) $0.10 

Triangular  bandage .  10 

Medium   compress .  05 


Total 


Stretcher   (United  States  Army  type) 5.50 

AVoolen  blanket 1.  75 

Rubber   blanket 1.  75 

Splints L .  75 

Rubber  bag .  4. 50 


Total 14.  25 

UNDERGROUND    DRESSING    STATIONS. 

First-aid  dressing  stations  should  be  maintained  near  the  bot- 
tom of  the  shaft  or  slope  and  at  a  central  sidetrack.  One  first- 
aid  cabinet  should  be  available  for  every  100  men  or  less.  At 
least  one  man  out  of  every  10  employees  should  carry  a  first-aid 
packet,  which  should  be  refilled  when  necessary. 

SURFACE    HOSPITAL    ROOM. 

Where  a  large  number  of  men  are  employed,  there  should  be 
available  on  the  surface  a  room  provided  writh  suitable  hospital 
facilities  and  having  a  surgeon*  in  attendance.  The  building 
should  be  as  close  as  possible  to  the  entrance  to  the  mine  and 
should  be  supplied  with  the  following  articles,  all  furniture  and 
utensils,  except  perhaps  the  chairs,  to  be  covered  with  heavy 
white  enamel.  The  prices  indicated  are  subject  to  fluctuation. 


FIRST-AID  EQUIPMENT.  11 

Operating  table  with  cushions $25.00 

Instrument  table 7.  00 

2  chairs 9.00 

1  sterilizer  for  instruments 10.  00 

Instrument  wall  case 4.  50 

1  basin .  45 

1  pitcher .  75 

2  new  galvanized-iron  buckets 1.  00 

6  sterile  sheets  in  wrappers 3.  50 

12  sterile  towels  in  wrappers 2.  00 

10  yards  of  gauze .  75 

1  box  for  holding  sheets,  towels,  and  gauze_  .  50 

3  hand  brushes .15 

1  pint  of  tincture  of  green  soap .  50 

250  c.  c.  of  tincture  of  iodine .  75 

1  pint  of  alcohol .  25 

One-half    pint    of    benzine    for    removing 

grease ..  10 


Total .     66.  20 

A  pair  of  tweezers  for  removing  splinters  and  two  1-quart 
hot-water  bottles  might  be  included  in  the  equipment  prescribed. 

SUGGESTIONS. 

The  authors  of  this  report  make  the  following  suggestions : 

1.  That  as  far  as  possible  first-aid  training  be  given  under 
the  immediate  supervision  of  a  regularly  registered  and  quali- 
fied physician; 

2.  That  there  be  close  cooperation  with  the  first-aid  depart- 
ment of  the  American  National  Red  Cross  in  first-aid  work; 


12      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

3.  That  all  examinations  for  first-aid  certificates  be  held  by  a 
qualified  physician  and  conform  with  such  standards  as  may  be 
laid  down  by  the  Bureau  of  Mines ; 

4.  That  it  be  an  imperative  rule  that  in  all  first-aid  contests 
the  judges   shall  be  regularly   qualified   physicians   trained   in 
first-aid  wrork ; 

5.  That  where  it  is  possible  every   employee  in   a  mine  be 
trained  in  first-aid  work,  but  if  this  is  impossible  that  at  least 
one  out  of  every  10  employees,  both  underground  and  on  the 
surface,  receive  such  training. 

CARING  FOB  THE  INJURED. 

Mining  is  one  of  the  most  hazardous  employments ;  therefore 
it  is  especially  important  that  miners  know  something  about 
caring  for  the  injured. 

When  an  accident  occurs  in  a  mine  it  is  usually  under  the 
worst  conditions ;  the  doctor  and  the  hospital  are  far  from  the 
scene  of  the  trouble ;  if  caused  by  an  explosion  or  fall  of  roof, 
the  passageways  may  be  so  blocked  by  falls  that  it  is  impossible 
to  get  the  injured  man  to  fresh  air  promptly ;  it  may  be  hours  be- 
fore the  physician  or  surgeon  sees  the  case.  Hence  it  will  readily 
be  seen  what  might  happen  if  nothing  were  done  for  the  patient. 
Death  may  occur  from  bleeding  or  shock,  a  simple  fracture  may 
be  converted  into  a  compound  fracture  by  ignorant  or  careless 
handling,  and  wounds  may  become  infected.  These  conditions 
are  in  contrast  with  those  that  surround  a  man  who  has  been 
injured  and  is  under  the  care  of  a  man  skilled  in  first  aid :  The 
bleeding  will  be  stopped,  the  shock  treated,  the  wound  dressed, 
the  fracture  properly  splinted,  the  pain  relieved,  and  the  patient 
made  warm ;  and  he  will  be  stronger  and  in  a  safer  and  better 
condition  when  he  reaches  the  physician. 


GENERAL  DIRECTIONS.  13 

GENERAL  DIRECTIONS. 

When  a  person  is  injured  some  one  should  take  command  and 
render  first  aid.  In  the  past  many  deaths  have  resulted  from 
the  fact  that  no  one  took  charge  of  the  injured  person.  The 
only  way  to  prevent  this  is  for  every  employee  to  acquire  a 
knowledge  of  first  aid.  The  person  assuming  charge  should 
look  the  man  over  carefully  to  find  how  badly  he  has  been 
injured  and  when  fully  satisfied  he  should  proceed  to  give  orders. 
Don't  attempt  any  unnecessary  movements  of  the  patient's  body 
or  limbs.  See  that  the  injured  part  is  in  a  position  as  nearly 
normal  as  possible,  except  in  case  of  dislocation,  which  should 
be  dressed  in  the  line  of  deformity.  Look  for  hemorrhage, 
wounds,  shock,  fractures,  dislocations,  burns,  etc.  In  exam- 
ining the  injured  person,  do  not  take  off  his  clothes  in  the 
usual  way,  as  you  may  cause  him  unnecessary  suffering  and 
make  his  injury  worse.  If  the  injury  is  of  the  arm,  leg,  or  body, 
rip  or  cut  the  clothing  from  the  injured  part,  preferably  by  rip- 
ping the  seams.  Do  not  move  the  person  until  you  are  sure  or 
have  a  clear  idea  of  what  the  injury  is.  If  hemorrhage  is  pres- 
ent, stop  the  flow  of  blood.  If  you  find  a  broken  bone,  fix  the 
parts  without  undue  handling.  The  proper  treatments  for  dif- 
ferent kinds  of  injuries  are  discussed  under  separate  heads. 

Be  calm  and  quiet.  Keep  onlookers  away  from  the  injured 
person.  Don't  wait  a  moment  for  a  doctor,  as  delay  is  dan- 
gerous. Endeavor  to  make  the  patient  comfortable  by  doing 
whatever  is  necessary  and  no  more.  Loosen  all  tight  clothing, 
especially  about  the  neck,  chest,  and  waist.  If  the  injured  per- 
son has  a  flushed  face,  put  something  under  his  head  to  raise  it. 
If  his  face  is  pale,  his  head  should  be  lowered.  If  the  patient 


14      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

vomits,  turn  his  head  to  one  side  so  that  the  vomited  matter 
will  not  get  into  his  windpipe  and  choke  him.  Never  give  an 
unconscious  person  water,  whisky,  or  other  liquid,  as  it  may 
enter  his  windpipe  and  strangle  him ;  however,  if  the  injured  per- 
son is  conscious  give  all  the  water  he  wants,  but  give  it  slowly 
and  in  sips.  A  seriously  injured  person  should  be  kept  lying 
down  and  covered  with  blankets,  brattice  cloth,  or  clothing  of 
some  sort.  Don't  give  whisky  or  brandy  as  stimulants  at  any 
time,  especially  (in  connection  with  injuries  of  the  head.  If  you 
have  to  give  a  stimulant  to  a  person  in  shock,  always  use  aro- 
matic spirits  of  ammonia,  hot  coffee,  hot  tea,  or  hot  water. 

Look  for  and  know  exactly  where  the  injury  is  before  at- 
tempting to  treat  it.  If  necessary,  remove  some  clothing,  but 
do  it  by  ripping  the  seams  of  the  garment  or  by  cutting  the 
clothes.  If  the  regular  first-aid  materials  are  not  at  hand, 
make  your  own  splints,  tourniquets,  stretchers,  etc.,  of  mate- 
rial that  is  near  the  place  of  accident.  When  you  find  several 
injuries,  treat  the  most  severe  one  first. 

Always  cheer  your  patient  and  keep  him  hopeful.  Keep  him 
warm  with  blankets,  brattice  cloth,  clothing,  hot-water  bottles, 
safety  lamps,  hot  bricks,  or  hot  stones;  but  hot  objects  should 
be  protected  so  that  they  will  not  burn  the  patient. 

WHAT  A  FIRST- AID  .  MAN   SHOULD  DO. 

Be  calm. 

Take  command  and  give  orders. 

Find  location  of  the  injury. 

Know  what  you  want  to  do  and  do  it. 

Keep  onlookers  away  from  the  patient. 

Use  a  knife  or  scissors  to  remove  clothing. 


WHAT  A  FIRST-AID  MAN  SHOULD  DO.  15 

Look  for  red  spurting  blood  and  check  it  by  tourniquet  or  by 
pressure  of  finger  over  blood  vessel. 

Look  for  shock;  if  present,  lower  head  of  patient,  apply 
blankets  and  wrapped  hot-water  bottles ;  and  give  aromatic  spir- 
its of  ammonia  in  water,  if  patient  is  conscious. 

Look  for  fractures;  never  remove  a  patient,  unless  absolutely 
necessary,  until  splints  have  been  applied. 

Place  bandage  compress  over  compound  fracture  before  ap- 
plying splints. 

Cover  all  wounds  with  bandage  compress  and  bandage. 

The  fingers  or  instruments  should  not  touch  a  wound. 

Remove  a  foreign  object  from  a  wound,  if  you  do  not  have  to 
put  your  lingers  into  the  wound  or  touch  the  edges  of  the 
wound. 

Exclude  air  as  quickly  as  possible  from  burned  surfaces  by 
using  picric  acid  gauze  or  other  material. 

Leave  reductions  of  dislocations  or  fractures  for  the  sur- 
geon, except  dislocation  of  jaw  or  finger. 

Only  part  of  your  work  is  completed  when  the  patient  is 
ready  for  the  stretcher. 

Unnecessary  or  rough  handling  of  a  patient'  may  undo  all 
your  work. 

Slowly  place  patient  on  stretcher,  avoiding  jerky  movements, 
and  carry  him  to  safety. 

DON'TS. 

Don't  touch  a  wound  with  your  fingers  or  any  instrument. 
Don't  put  an  unclean  dressing  or  cloth  over  a  wound. 
Don't  allow  bleeding  to  go  unchecked. 
Don't  move  a  patient  unnecessarily. 


16      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

Don't  allow  a  patient  with  a  fracture  or  suspected  fracture  to 
be  moved  until  splints  have  been  applied. 

Don't  fail  to  put  plenty  of  padding  between  limb  and  splint. 

Don't  neglect  shock. 

Don't  burn  a  patient  with  an  unwrapped  hot-water  bottle  or 
other  heated  object. 

Don't  fail  to  give  artificial  respiration  when  needed. 

Don't  fail  to  pull  the  tongue  forward  when  giving  artificial 
respiration. 

Don't  fail  to  remove  false  teeth,  tobacco,  and  chewing  gum 
from  the  mouth  of  an  unconscious  person. 

Don't  remove  the  clothing  from  the  injury  in  the  usual  way. 

Don't  permit  air  to  reach  a  burned  surface. 

Don't  wash  wounds. 

Don't  put  drugs  in  a  wound. 

Don't  reduce  dislocations,  except  of  the  finger  and  lower  jaw. 

Don't  put  a  quid  of  tobacco  on  a  wound. 

Don't  leave  a  tourniquet  on  over  20  minutes  without  loosening. 


ANATOMY  OP  THE  HUMAN  BODY. 

In  order  to  practice  first  aid  properly  one  should  know  some- 
thing about  the  bones,  heart,  arteries,  veins,  small  blood  vessels, 
principal  organs,  and  muscles  of  the  human  body. 

The  human  body  is  composed  of  solids  and  fluids.  The  blood  is 
about  one-thirteenth  the  weight  of  the  body;  for  instance,  if  a 
man  weighs  130  pounds  he  will  have  10  pounds  of  blood. 

SKELETON. 

The  human  skeleton  (fig.  2.)  is  the  framework  of  the  body 
and  is  composed  of  three  parts:  The  head,  the  trunk,  and  the 
extremities.  There  are  202  bones  in  the  body,  but  for  the  pur- 
poses of  first  aid  only  a  few  of  these  are  here  considered.  There 
are  long  bones  that  support  the  body  and  act  as  levers;  short 
bones  for  strength ;  flat  bones  to  protect  the  vital  organs  and 
for  muscle  attachment;  and  irregular  bones,  as  the  backbone 
and  the  jaw. 

The  skull  has  22  bones,  of  which  8  form  the  upper  part,  or 
cranium,  and  14  the  face. 

The  trunk  is  composed  of  the  backbone,  breastbone,  ribs,  and 
pelvis.  The  backbone  is  made  up  of  33  bones,  which  are  joined 
together  by  ligaments,  forming  the  spinal  column,  through  which 
the  spinal  cord  passes.  The  chest  in  front  has  a  breastbone 
and  12  ribs  on  each  side ;  behind,  the  backbone.  The  first  7  pairs 
of  ribs  are  attached  to  the  breastbone,  the  remaining  pairs  being 
attached  in  front  to  the  cartilage.  The  lower  two  have  no  at- 

17 


18      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


tachroent  in  front  and  are  known  as  floating  ribs.    All  of  the  ribs 

are  attached  to  the  backbone 
behind.     The  breastbone 
forms  the  front  wall  of  the 
chest  and  is  about  6  inches 
long.    At  the  upper  end  it  is 
broad  and  on  each  side  has 
a    depression    that    fits    the 
end  of  the  col- 
lar  bone ;    be- 
low   it    tapers 
to  a  point. 

The  pelvis  is 
a  wide,  strong, 

bony  basin  made  up  of  the 
two  haunch  bones  and  the 
sacrum,  which  is  the  lower 
end  of  the  backbone.  The 
haunch  bones  form  the  front 
and  the  sides  and  the  sa- 
crum the  back  wall  of  the 
basin.  The  pelvis  supports 
the  trunk,  and  the  lower 
limbs  are  joined  to  it  at 
the  hip  joints. 

The  trunk  is  divided  by  a 
large  muscle  called  the  dia- 
phragm into  two  cavities — 

FIGURE  2. — The  human  skefeton.  chest  and  abdomen.  The 
chest  cavity  contains  the  lungs,  heart,  gullet,  windpipe, 
and  large  blood  vessels.  The  abdomen  contains  the  stomach, 


ANATOMY  OF  THE  HUMAN  BODY.  19 

large    blood    vessels,    intestines,    liver,  kidneys,    spleen,    and 
bladder. 

Each  upper  extrem- 
ity has  1  collar  bone, 
1  shoulder  blade,  1 
arm  bone,  2  forearm 
bones,  8  wrist  bones, 
5  hand  bones,  and  14 
finger  bones.  Each 
lower  extremity  has  I 
thigh  bone,  2  leg  bones, 
1  kneecap.  7  ankle 
bones,  5  foot  bones, 
and  14  toe  bones. 

JOINTS. 

Where  two  or  more 
bones  come  together 
they  form  a  joint  and 
are  held  in  position  by 
bands  called  ligaments. 

MUSCLES. 

Muscles  or  flesh  give 
shape  to  the  body,  and 
by    shortening    or     FIGUUE    3.— The^urface    muscles    of    the 
lengthening  they  cause  body, 

the  parts  to  which  they  are  attached  to  move.   (See  fig.  3.) 
51607°— 17 3 


20      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  ]VTINERS. 


TENDONS. 

Tendons  are  strong,  white,  fibrous  cords  that  attach  muscles 
to  bone. 

SKIN. 

The  skin  is  the  protective 
covering  of  the  body  and  is  the 
organ  of  the  sense  of  touch. 
It  also  performs  the  function 
of  getting  rid  of  some  of  the 
impurities  of  the  body.  At  the 
openings  leading  to  or  from 
the  interior  of  the  body  it  be- 
comes the  mucous  membrane. 

BLOOD  SUPPLY. 

The  blood  carries  nourish- 
ment to  the  different  parts  of 
the  body  by  means  of  closed 
tubes  called  blood  vessels  (fig. 
4),  and  it  is  kept  moving  by 
the  pumplike  action  of  the 
heart.  It  also  furnishes  heat 
and  oxygen  to  all  parts  of  the 
body  and  carries  waste  matter 
from  all  the  tissues  to  such 
organs  as  the  lungs,  kidneys, 
skin,  and  bowels,  whose  work 
FIGURE  4.— The  principal  arteries  is  to  separate  it  and  send  it 
and  veins  of  the  body.  out  of  the  body. 


ANATOMY  OF  THE  HITMAN  BODY.  21 

HEART. 

The  heart  is  a  hollow,  muscular  organ  about  the  size  of  a 
man's  fist,  situated  in  the  chest  behind  and  somewhat  to  the  left 
of  the  breastbone.  It  pumps  pure  blood  through  the  arteries 
to  all  parts  of  the  body,  just  as  a  fan  forces  pure  air  through  a 
mine.  The  impure  blood  is  carried  through  the  veins  back  to 
the  right  side  of  the  heart,  which  sends  it  to  the  lungs  to  be 
purified ;  it  is  then  returned  to  the  left  side  of  the  heart  and 
sent  through  the  body  again.  The  heart  acts  like  a  double 
pump,  one  side  of  which  forces  the  fresh  blood  through  the 
body,  the  other  side  forcing  the  impure  blood  to  the  lungs.  The 
heart  contracts,  or  beats,  about  72  times  a  minute, 

BLOOD  VESSELS. 

The  blood  vessels  are  the  arteries,  veins,  and  capillaries, 
through  which  the  blood  is  conveyed  to  and  from  all  parts  of 
the  body.  The  arteries  carry  the  blood  from  the  heart,  and  they 
divide  and  subdivide  until  they  become  very  small  in  size  and 
are  known  as  capillaries.  These  finally  enlarge  and  join,  form- 
ing the  veins,  through  which  the  blood  is  returned  to  the  heart. 
The  rich,  red  blood  flows  through  the  arteries  in  spurts,  forming 
the  pulse  beat,  which  is  conveniently  felt  at  the  wrist  and  tem- 
ples. When  an  artery  is  cut  the  blood  spurts  out  in  jerks  and 
is  bright  red  in  color ;  when  a  capillary  is  cut  the  blood  is  brick 
red  in  color  and  oozes  slowly  from  the  wound ;  the  blood  in  the 
veins  is  dark  red  and  the  flow  is  continuous.  Figure  5  shows 
the  relation  of  the  principal  arteries  to  the  bones.  The  points 
at  which  pressure  may  best  be  applied  to  stop  bleeding  are  indi- 
cated. 


22      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


RESPIRATION. 

Respiration  means  breathing, 
taking  in  pure  air  and  driving 
out  the  impurities  that  the 
lungs  have  separated  from  the 
blood.  The  breathing  apparatus 
consists  of  the  nose,  throat, 
windpipe,  and  lungs. 

The  principal  use  of  the  nose 
is  to  warm,  filter,  and  moisten 
the  air  before  it  reaches  the 
lungs;  in  the  nose  also  is  the 
sense  of  smell  which  to  a  great 
extent  warns  a  person  of  the 
presence  of  some  harmful  gases. 
The  throat  is  a  continuation 
of  the  nose  and  the  mouth,  and 
at  its  lower  end  are  two  open- 
ings ;  the  one  behind,  called  the 
gullet,  leads  into  the  stomach; 
the  one  in  front,  called  the 
windpipe,  leads  to  the  lungs. 

At  the  top  of  the  windpipe  is 
the  larynx,  in  which  are  the 
cords  of  speech  by  which  the 
voice  is  formed.  When  swal- 
lowing, the  larynx  is  closed  by 
FIGURE  5.— Relation  of  principal  a  flapi{ke  covering  known  as 
arteries  to  the  bones.  Points  tne  epiglottis  which  prevents 
where  pressure  may  best  be  ap-  „  ,  ~_  ,.  .  ,  „ 
plied  to  stop  bleeding  are  indi-  food  and  h<luld  from  entering 
cated.  the  windpipe. 


ANATOMY  OF  THE  HUMAN  BODY.  23 

LUNGS. 

The  lungs  are  two  cone-shaped  bodies,  which  are  soft,  spongy, 
and  elastic.  The  outside  of  each  lung  is  covered  by  a  closed  sac 
called  the  pleura.  The  inner  part  of  the  lungs  communicates 
freely  with  the  outside  air  through  the  windpipe.  The  outside 
of  the  lungs  is  protected  from  air  pressure  by  the  walls  of  the 
chest.  The  air  pressure  on  the  inside  of  the  lungs  expands 
them  until  they  fill  the  entire  chest  cavity.  If  any  air  gets 
through  the  chest  wall,  or  if  the  wall  of  the  lung  is  pierced  so 
that  the  air  from  the  outside  can  communicate  \vith  the  pleural 
sac,  the  lungs  shrink,  because  the  air  pressure  is  equalized  on 
the  outside  and  inside  of  the  chest  cavity. 

The  purification  of  the  blood  in  the  lungs  is  readily  effected, 
because  only  a  very  delicate  wall  is  between  the  air  on  one  side 
and  the  blood  on  the  other,  so  that  the  gases  are  easily  ex- 
changed between  the  two.  The  blood  in  the  veins  from  the 
system  is  brought  to  the  capillaries  of  the  lungs,  where  the  air 
cells  separate  the  carbonic  acid  gas  and  waste  matter  with 
which  the  blood  is  laden.  A  new  supply  of  oxygen  is  taken  up 
by  the  red  blood  cells. 

Breathing  is  an  act  over  which  we  have  little  control.  It 
occurs  in  health  about  sixteen  to  twenty  times  per  minute. 
Oxygen  is  absolutely  necessary  to  human  life.  If  a  person 
breathes  bad  air  continuously,  his  health  will  break  down  and 
disease  will  follow.  To  insure  health  a  person  requires  1,000 
cubic  feet  of  air  space,  which  is  equal  to  the  space  in  a  room 
10  feet  square  and  10  feet  high,  and  the  air  breathed  should  be 
frequently  renewed  through  proper  ventilation.  This  means 
that  the  air  should  be  kept  in  motion,  and  the  relative  humidity 
and  temperature  should  be  approximately  such  as  insure  health. 


24      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 
DIGESTIVE  SYSTEM. 

The  digestive  system  consists  of  a  long  tube  which  comprises 
the  mouth,  throat,  gullet,  stomach,  and  bowels,  together  with  the 
liver  and  other  glands.  This  tube  is  about  30  feet  long  and 
extends  from  the  mouth  to  the  rectum.  Its  functions  are  to 
separate  the  nourishment  from  the  food,  to  expel  the  waste 
part  from  the  body,  and  to  arrange  the  nutritive  material  in  a 
form  that  can  be  taken  up  by  the  blood  and  used  for  food  by 
the  tissues.  (See  pp.  127-134.) 

EXCRETORY  SYSTEM. 

Excretion  means  the  removing  of  all  waste  matter  from  the 
tissues.  The  waste  may  be  removed  by  means  of  perspiring 
through  the  skin,  by  urine  from  the  kidneys,  in  carbonic  acid 
gas  from  the  lungs,  and  by  the  bowel  movements.  Life  and 
health  depend  upon  the  body  throwing  off  these  wastes  or 
poisons.  (See  pp.  134-136.) 

NERVOUS  SYSTEM. 

The  different  parts  of  the  body  are  kept  in  touch  with  each 
other  by  the  nervous  system,  and  the  functions  of  the  organs 
are  controlled  and  regulated  by  it.  The  nervous  system  is 
composed  of  nerves  and  nerve  cells  or  centers ;  most  of  the  lat- 
ter are  in  the  brain  and  the  spinal  cord.  The  nerves  are  round 
white  cords  consisting  of  nerve  fibers,  which  form  connections 
between  the  centers  and  the  ends  of  the  nerves.  The  fibers 
transmit  nervous  impulses  and  are  of  two  kinds,  according  to 
the  function  that  they  perform.  One  carries  sensations,  such  as 
pain,  heat,  and  cold,  and  the  other  causes  movements  of  the. 


ANATOMY  OF  THE  HUMAN  BODY.  25 

body.     The  nervous  system  plays  an  important  part  in  injuries, 
as  there  would  be  no  shock  if  the  nerve  centers  were  not  affected. 

EPILEPSY. 

A  person  in  a  mine  may  have  an  attack  of  epilepsy,  and  fre- 
quently this  condition  is  mistaken  and  the  patient  is  mistreated 
and  mishandled. 

Epilepsey,  or  falling  sickness,  is  a  nervous  disorder ;  the  patient 
will  have  a  fit  or  convulsion  and  fall  to  the  ground.  The  person 
is  usually  warned  of  the  oncoming  attack.  He  may  be  de-  . 
pressed  or  joyful  or  there  may  be  a  change  in  his  facial  expres- 
sion. Often  he  feels  a  breath  of  air  blowing  on  some  part  of 
the  body,  passing  upward  to  his  head,  with  pain  in  his  limbs 
or  internal  organs  (stomach,  etc.),  or  his  muscles  may  tremble 
or  contract. 

If  standing,  he  will  cry  out  or  scream  and  fall  to  the  ground 
unconscious.  His  muscles  become  stiff,  his  head  is  turned 
to  one  side  by  jerks,  and  breathing  for  the  moment  is  stopped ; 
his  face  is  at  first  pale,  then  livid.  This  stage  lasts  about  one- 
half  minute,  followed  by  rolling  of  the  eyes;  he  may  bite  his 
tongue  and  cheeks,  and  at  the  same  time  the  bladder  and  bowels 
may  act.  This  stage  lasts  a  few  minutes  and  the  patient  slowly 
regains  consciousness  and  may  then  fall  asleep. 

Treatment. — Do  not  try  to  restrain  his  convulsive  movements, 
but  see  that  he  does  not  injure  himself  as  by  falling  into  a  fire 
or  down  a  shaft.  Lay  the  patient  on  his  back.  Remove  from 
his  mouth  any  foreign  bodies,  such  as  false  teeth,  tobacco,  or 
gum.  Cover  him  with  blankets.  Do  not  give  him  anything  by 
mouth.  Loosen  all  tight  clothing  about  his  neck,  chest,  and 


26      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

abdomen.  Place  a  piece  of  gauze  or  a  pad  between  the  teeth. 
Dash  cold  water  on  his  face  and  chest.  Carry  the  patient  home 
and  have  him  rest. 

If  a  patient  tells  you  that  an  attack  is  coming  on,  you  may 
be  able  to  ward  it  off  by  compressing  his  hand  firmly. 

SHOCK. 

Shock  is  a  profound  impression  made  on  the  nervous  system. 
It  occurs  in  more  or  less  degree  following  all  accidents,  and  in 
case  of  fright,  anger,  or  surgical  operations.  Shock  is  danger- 
ous and  should  be  given  prompt  attention.  Allowing  a  person 
to  see  his  own  injury  often  causes  shock,  especially  if  there  is 
much  bleeding.  When  a  person  is  suffering  from  shock,  his  face 
is  pale  and  has  an  anxious  expression,  the  eyelids  droop,  the 
eyes  are  dull  and  the  pupils  large,  the  skin  is  clammy  and 
covered  with  cold  sweat.  The  injured  man  is  somewhat  stupid 
and  takes  little  interest  in  things  about  him.  He  may  suffer 
from  nausea  and  vomiting.  He  may  answer  questions  slowly. 
He  may  be  partly  or  totally  unconscious,  or  his  mind  may 
wander.  Usually  he  is  perfectly  quiet  and  will  not  move 
unless  disturbed.  Breathing  is  shallow  and  feeble;  the  pulse 
is  rapid  and  weak,  and  may  not  be  felt  at  the  wrist.  When 
this  condition  is  observed,  send  for  a  doctor.  Place  the  per- 
son in  a  comfortable  position  with  his  head  low,  unless  there 
is  a  fracture  of  the  skull  or  severe  hemorrhage  from  the  head. 
Remove  from  his  mouth  all  foreign  bodies,  such  as  false  teeth, 
tobacco,  or  gum.  Wrap  the  person  in  warm  blankets,  clothing, 
or  brattice  cloth.  If  conscious,  give  aromatic  spirits  of  am- 
monia— a  teaspoonful  in  a  half  glass  of  water — hot  coffee,  hot 


ANATOMY  OF  THE  HUMAN  BODY.  27 

tea,  or  hot  water.  If  he  is  unconscious  do  not  give  him  any- 
thing by  mouth,  but  pour  aromatic  spirits  of  ammonia  on  a  cloth 
and  place  it  under  his  nose.  Place  hot-water  bottles,  hot  bricks,  or 
lighted  safety  lamps  around  him  under  the  coverings,  but  make 
sure  that  they  are  wrapped  with  cloth  or  paper  so  as  to  prevent 
burns.  If  the  person  is  unconscious  he  can  not  tell  you  that 
the  bricks,  bottles,  or  lamps  are  too  hot.  Rub  his  legs  and  arms 
toward  the  body  under  the  blankets,  but  do  not  uncover  him. 
A  light  hot-water  bottle,  wrapped  in  cloth  or  paper  and  placed 
over  the  heart,  is  a  good  stimulant. 

Although  shock  is  dangerous  and  commonly  follows  injuries, 
it  must  not  be  forgotten  that  the  patient  may  require  treatment 
for  something  still  more  dangerous;  as,  for  instance,  severe 
bleeding,  which  must  be  checked. 


ELECTRIC  SHOCK. 

Electricity  causes  shock  by  paralyzing  the  nerve  centers  that 
control  breathing  or  by  stopping  the  regular  beat  of  the  heart. 
Accidents  from  electricity  are  common  in  mines.  Electric  cir- 
cuits used  in  mines  carry  250  to  3,000  volts. 

The  symptoms  of  electric  shock  are  sudden  loss  of  conscious- 
ness, absence  of  respiration — which,  if  present,  is  slight  and 
can  not  be  observed — weak  pulse,  and  burns  at  the  point  of 
contact  with  the  conductor  of  electricity.  Always  rescue  the  per- 
son as  quickly  as  possible,  being  careful  not  to  get  in  contact  with 
the  live  wire  or  other  conductor.  Lose  no  time  in  looking  for  a 
switch  to  turn  off  the  current.  In  the  event  that  there  is  no  switch 
near,  take  a  drill,  mine  auger,  bar,  or  piece  of  wire  and  throw  it 
quickly  across  the  trolley  and  the  rail,  taking  particular  care  to 
release  your  hold  of  the  instrument  before  it  touches  the  live 
wire.  By  so  doing  the  circuit  breaker  in  the  power  house  will 
be  thrown  out  and  the  current  cut  off.  Leave  the  auger  or 
other  instrument  across  the  wire,  so  that  the  circuit  breaker  will 
be  thrown  out  continuously.  Such  action  may  cause  injury  to 
other  working  parts  of  the  mine,  but  when  a  human  life  is  at 
stake  all  the  wires  should  be  cut  if  necessary.  Life  should  come 
first  and  the  mine  property  afterwards.  A  dry,  long-handled 
shovel  wrill  be  of  service  in  removing  the  patient  from  the  wire. 

If  no  wire,  drill,  or  other  instrument  long  enough  to  reach  from 
the  wire  to  the  rail  is  at  hand,  one  may  proceed  to  remove  the 
victim  from  the  live  wire,  but  first  get  a  dry  board  or  piece  of 
28 


SUFFOCATION  OR  ASPHYXIATION.  29 

thick  paper  and  put  it  under  your  feet,  and  protect  the  hand 
you  use  with  your  cap,  coat,  or  any  dry,  nonconducting  material, 
so  as  not  to  make  a  circuit.  If  possible,  use  one  hand  only,  plac- 
ing the  other  behind  you.  If  both  hands  are  used  to  remove  the 
person  from  the  wire,  make  sure  that  both  your  hands  and  your 
feet  are  well  insulated,  so  that  you  will  not  be  caught  in  the  same 
contact.  Another  way  is  to  take  your  belt,  handkerchief,  coat, 
or  piece  of  dry  rope  and  loop  it  over  the  victim's  foot  or  head  if 
he  is  lying  on  the  wire,  and  thus  pull  him  off.  If  an  ax  is  near 
at  hand,  use  it  to  cut  the  wire,  but  first  make  sure  that  the  handle 
is  dry,  or  wrap  it  with  a  coat  or  other  dry  nonconducting  mate- 
rial. Or  you  may  use  a  dry  board,  dry  cloth,  or  dry  rope  to  pull 
the  wire  away  from  the  patient. 

TREATMENT   FOR   ELECTRIC   SHOCK. 

After  the  person  has  been  taken  from  the  wire  turn  him  over 
on  his  face,  remove  all  foreign  bodies  from  his  mouth,  such  as 
false  teeth,  tobacco,  or  gum,  pull  and  keep  the  tongue  forward, 
turn  his  head  to  one  side,  resting  it  on  his  forearm  so  that  his 
mouth  and  nose  will  not  come  in  contact  with  the  ground,  and 
extend  his  other  arm  forward.  Do  not  wait  to  loosen  his  cloth- 
ing. Start  the  Schaefer  (or  prone)  method  of  artificial  respira- 
tion without  delay. 

SUFFOCATION   OB  ASPHYXIATION. 

A  victim  of  suffocation  or  asphyxiation  becomes  unconscious, 
his  lips  and  ear  lobes  become  blue,  his  pulse  and  breathing  stop, 
and  his  pupils  become  dilated.  The  cause  may  be  something 
blocking  the  windpipe  and  preventing  the  air  from  getting  into 
the  lungs,  or  inhalation  of  harmful  gases.  Due  care  should  be 


30      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

exercised  by  the  rescuer  to  protect  himself.  Unless  the  air 
where  the  victim  is  found  is  good,  immediately  get  the  person 
to  pure  air  and  perform  the  Schaefer  method  of  artificial 
respiration. 

GAS  POISONING.0 

The  most  common  gases  found  in  a  mine  are  black  damp  (a 
mixture  of  nitrogen  and  carbon  dioxide),  white  damp  (carbon 
monoxide),  and  fire  damp  (inflammable  gas,  chiefly  methane). 

Fire  damp  has  no  effect  on  the  human  system.  Only  when  a 
sufficient  amount  has  been  generated  to  reduce  the  quantity  of 
normal  air  present  does  it  interfere  with  breathing.  When 
present,  however,  in  proper  proportions,  it  is  highly  explosive. 
Therefore  great  care  should  be  exercised  in  using  naked  lights. 

The  breathing  of  black  damp  and  white  damp,  particularly 
the  latter,  is  very  dangerous.  Black  damp  is  usually  recognized 
by  its  action  on  the  flame  of  a  safety  lamp.  In  old  and  un- 
ventilated  workings  and  at  the  bottom  of  sumps,  in  reopening 
old  shafts,  great  care  should  be  taken.  When  a  person  works 
in  black  damp  he  is  affected  not  only  by  the  damp  but  also 
from  a  lack  of  oxygen.  The  symptoms  of  danger  from  breath- 
ing black  damp  occur  far  in  advance,  but  with  white  damp 
there  may  be  no  such  warning.  In  bad  air  the  amount  of 
black  damp  would  give  warning  of  the  next  and  more  serious 
danger — want  of  oxygen.  The  man  working  in  bad  air  will 
find  that  his  usual  work  is  more  tiring  than  when  working  in 
pure  air,  and  that  he  will  be  compelled  to  take  frequent 
rests.  A  severe  headache  is  made  worse  by  stooping  and  is 

a  For  methods  of  detecting  these  gases  see  Bureau  of  Mines  Miners' 
Circulars  12  and  14,  listed  on  page  142. 


CARBON  MONOXIDE  OR  WHITE  DAMP.  31 

often  accompanied  by  a  sick  stomach.  In  severe  cases  the  power 
of  the  limbs  is  interfered  with,  causing  the  victim  to  stagger. 
The  face  becomes  flushed  and  the  flush  deepens  and  becomes 
bluish.  Often,  if  only  a  small  percentage  of  black  damp  is 
present  and  most  of  the  oxygen  has  been  replaced  by  nitrogen, 
the  person  exposed  to  such  an  atmosphere  may  collapse  into  un- 
consciousness with  practically  no  warning.  No  man  should  be 
permitted  to  work  where  black  damp  is  present. 

CARBON  MONOXIDE  OB  WHITE  DAMP. 

Many  miners  state  that  they  are  able  to  tell  the  presence  of 
carbon  monoxide  by  the  sweetish  odor  present.  This  odor  is 
due  not  to  the  carbon  monoxide  but  to  other  decomposition 
products  in  the  atmosphere,  such  as  the  volatile  products  given 
off  by  a  fire,  or  such  as  are  caused  by  wood  rotting,  or  by  the 
oxidation  of  coal.  Although  there  may  be  only  a  very  small  per- 
centage of  carbon  monoxide  present  in  the  air  that  is  breathed, 
the  action  of  the  gas  is  cumulative ;  that  is,  the  carbon  monoxide 
is  gradually  but  continuously  taken  up  by  the  blood  and  displaces 
the  oxygen,  causing  the  body  to  suffer  from  oxygen  starvation. 
The  first  decided  symptoms,  during  rest,  make  their  appearance 
only  when  the  blood  is  saturated  with  about  30  per  cent  of  the 
gas.  Death  occurs  when  the  saturation  attains  about  80  per 
cent.  This  action  of  carbon  monoxide  accounts  for  many  lives 
that  have  been  lost. 

Another  feature  is  that,  if  one  is  working  in  such  an  atmos- 
phere, his  body  will  store  up  more  carbon  monoxide  than  if  he 
is  at  rest.  In  rescue  work  men  may  have  proceeded  a  consid- 
erable distance  in  foul  air  before  becoming  affected  and  have 
had  insufficient  oxygen-carrying  elements  in  the  blood  to  bear 


32      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

them  back  to  safety.  White-damp  poisoning  steals  upon  its  vic- 
tim in  such  a  way  that  he  may  become  saturated  with  the  damp 
before  he  is  aware  of  it.  In  some  cases  the  poisoning  takes 
effect  suddenly.  In  disasters,  many  men  have  been  found  dead 
in  their  places  with  their  picks  in  their  hands  as  if  working, 
others  have  been  found  in  positions  indicating  that  they  were 
taking  food  when  overcome. 

The  symptoms  are  numerous,  the  more  prominent  being  yawn- 
ing, giddiness,  ringing  in  the  ears,  weariness,  and  a  fluttering 
or  throbbing  of  the  heart,  which  is  a  late  symptom.  If  a  person 
gets  out  of  impure  air  into  good  air,  usually  these  symptoms 
pass  off,  leaving  perhaps  a  headache,  but  if  no  attention  is  paid 
to  the  symptoms  and  the  person  continues  working,  he  becomes 
more  affected  and  feels  that  his  legs  are  beginning  to  go  from 
under  him  and  usually  staggers  around  until  he  sinks  to  the 
ground  in  a  semiconscious  or  unconscious  condition. 

All  cases  may  not  begin  this  way.  The  symptoms  may  come 
on  so  gradually  that  the  body  becomes  full  of  the  poison  before 
the  person  is  aware  of  it,  and  he  falls  unconscious.  The  per- 
son's condition  from  exposure  to  black  damp  is  usually  due  to 
Lick  of  oxygen  in  the  air  that  he  breathes.  Exposure  to  white 
damp  destroys  the  hemoglobin  in  the  blood  so  that  it  will 
not  carry  oxygen  to  the  tissues  of  the  body.  In  treating  a  per- 
son that  is  suffering  from  either  black  damp  or  white  damp, 
always  administer  oxygen  when  making  use  of  artificial  res- 
piration. However,  if  the  oxygen  is  not  at  hand,  do  not  wait, 
but  start  the  Schaefer  method  of  artificial  respiration  after  the 
person  overcome  has  been  removed  to  fresh  air. 


ARTIFICIAL  RESPIRATION.  33 

DROWNING. 

The  most  important  essential  after  rescuing  a  drowning 
person  is  to  get  the  water  out  of  his  lungs  and  stomach.  Roll- 
ing him  on  a  barrel  is  desirable,  but  as  a  rule  a  barrel  is  not 
available.  As  a  substitute,  have  one  man  get  on  his  hands  and 
knees,  so  that  the  victim  can  be  placed  over  the  kneeling  man's 
back,  or,  if  you  are  alone  with  the  victim,  place  and  lock  your 
hands  underneath  the  patient's  stomach  and  lift  him  several 
times,  thus  bending  his  body  and  allowing  the  water  to  flow  out 
of  his  mouth.  Later  resort  to  artificial  respiration.  Usually 
after  a  person  has  been  immersed  in  water  for  five  minutes  life 
is  extinct.  There  have  been  victims  that  have  been  revived 
after  two  hours  of  artificial  respiration. 

ARTIFICIAL    RESPIRATION    BY    THE    SCHAEFER    OR 
PRONE   METHOD. 

Place  the  person  on  his  abdomen ;  remove  from  his  mouth  all 
foreign  bodies,  such  as  false  teeth,  tobacco,  and  gum;  pull  and 
keep  the  tongue  forward ;  turn  his  head  to  one  side  and  rest  it 
on  his  forearm,  so  that  the  mouth  and  the  nose  will  not  come  in 
contact  with  the  ground  and  extend  the  other  arm  forward. 
If  the  person  is  thin,  prepare  a  pad  of  folded  clothing,  blankets, 
or  brattice  cloth  and  place  it  under  the  lower  part  of  his  chest. 
Do  not  make  this  pad  too  thick.  Do  not  wait  to  loosen  the  vic- 
tim's clothing  but  begin  artificial  respiration  without  delay. 
An  assistant  may  remove  all  tight  clothing  from  the  victim's 
neck,  chest,  and  waist ;  blankets,  hot-water  bottles,  safety  lamps, 
or  hot  bricks  well  wrapped  in  paper  or  cloth  should  be  placed 
about  the  person  by  an  assistant. 


34      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

Kneel,  straddling  the  person's  thighs,  and,  facing  his  head, 
rest  the  palms  of  your  hands  on  his  loins — on  the  muscles  of 
the  small  of  his  back — with  your  thumbs  nearly  touching  each 
other  and  your  fingers  spread  over  his  lowest  ribs  (see  fig.  6)  ; 
with  arms  held  straight,  swing  forward  slowly  so  that  the 
weight  of  your  body  is  gradually  brought  to  bear  on  the  person 


FIGURE    6. — Schaefer    (or    prone)    method    of    artificial    respiration — 
Inspiration. 

(see  fig.  7).  This  operation,  which  should  take  three  to  four 
seconds,  must  not  be  violent,  lest  the  internal  organs  be  injured. 
The  lower  part  of  the  chest  and  also  the  abdomen  are  thus 
compressed  and  air  is  forced  out  of  the  lungs.  Now,  imme- 
diately swing  back  slowly  so  as  to  remove  the  pressure,  but 
leave  your  hands  in  place,  thus  returning  to  the  position  shown 
in  figure  6.  Through  their  elasticity  the  patient's  chest  walls 


ARTIFICIAL  RESPIRATION. 


35 


expand  and  his  lungs  are  thus  supplied  with  fresh  air.  After 
two  seconds  swing  forward  again  and  repeat  deliberately,  16  to 
18  times  a  minute,  the  double  movement  of  compressing  and 
releasing — causing  a  complete  respiration  in  about  four  seconds. 
If  a  watch  or  clock  is  not  available,  follow  the  natural  rate  of 
your  own  deep  breathing,  swinging  forward  with  each  expira- 
tion and  backward  with  each  inspiration. 


FIGURE    7. — Schaefer    (or    prone)    method    of    artificial    respiration — 
Expiration. 

Continue  artificial  respiration,  if  necessary,  for  at  least  three 
hours  without  interruption  until  natural  breathing  has  been 
restored  or  until  a  physician  arrives.  Even  after  natural 
breathing  begins  carefully  watch  that  it  continues.  If  it  stops, 
start  artificial  respiration  again. 

Do  not  give  any  liquids  whatever  by  mouth  until  the  person 
is  fully  conscious,  when  you  may  give  slowly  aromatic  spirits 
51607°— 17 4 


36      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

of  ammonia  (a  teaspoonful  in  half  a  glass  of  water),  hot  coffee, 
hot  tea,  or  water. 

Do  not  permit  bystanders  to  crowd  around.  The  assistant 
should  not  do  anything  that  will  interfere  with  the  operator. 

USE  OF  BESUSCITATION   DEVICES. 

As  pointed  out  in  Technical  Paper  77  of  the  Bureau  of  Mines, 
"  Report  of  the  Committee  on  Resuscitation  from  Mine  Gases," 
in  mild  cases  of  respiratory  failure,  or  even  when  breathing  is 
suspended,  manual  methods  should  be  used  at  once,  because 
there  is  a  chance  of  reviving  the  patient  if  resorted  to  imme- 
diately, but  "  if,  owing  to  delay,  the  cells  of  the  brain  have  been 
deprived  of  their  supply  of  oxygen  for  more  than  the  critical 
period  (rarely  more  than  10  minutes),  it  is  utterly  impossible 
for  any  later  treatment  to  restore  them  to  their  normal  con- 
dition." 

However,  as  the  breathing  may  be  so  faint  that  it  will  not  be 
detected  by  the  layman  or  first-aid  man,  even  if  the  person  seems 
to  be  dead,  it  is  advisable  that  artificial  respiration  be  begun 
at  once  and  continued  until  there  is  no  hope  of  reviving  him. 

When  the  quantity  of  fresh  air  supplied  to  the  patient  by  such 
artificial  respiration  is  small  or  insufficient,  as  is  likely  to  be 
the  case  if  the  patient  has  been  breathing  poisonous  gases,  it  is 
advisable  that  the  manual  method  be  supplemented  by  the  re- 
lease of  pure  oxygen  from  a  container  in  proximity  to  the 
patient's  nose  or  mouth,  but  avoiding  creating  any  pressure 
that  would  cause  injury  or  prevent  free  exhalation.  When 
oxygen  or  oxygen  and  air  are  given  the  manual  treatment 
should  not  be  stopped,  but  should  continue  as  long  as  there  is 
hope  of  reviving  the  patient. 


USE  OF  RESUSCITATION  DEVICES.  37 

Various  machines  have  been  devised  to  compel  or  assist  arti- 
ficial breathing.  The  committee  on  resuscitation  above  referred 
to  considered  that  devices  that  automatically  forced  respiration 
were  dangerous,  and  at  the  time  of  preparing  this  report  official 
approval  has  not  been  given  to  any  resuscitation  devices. 


DRESSINGS. 

Dressings  consist  of  bandages,  bandage  compresses,  and 
splints.  (See  fig.  1.) 

BANDAGES. 

Bandages  are  used  to  hold  dressings  and  splints  in  place,  to 
stop  bleeding  by  pressure,  and  to  serve  as  slings. 

TRIANGULAR    BANDAGE. 

The  triangular  bandage  is  recommended  by  the  Bureau  of 
Mines  because  it  is  easily  applied  and  can  be  handled  by  the 
first-aid  man  in  such  a  way  that  the  part  applied  to  the  wound 
will  not  be  soiled,  it  does  not  tend  to  slip  off  when  once  applied, 
and  it  is  usually  made  from  unbleached  cotton  cloth,  although 
any  kind  of  cloth  will  answer  the  purpose,  such  as  a  handker- 
chief, a  piece  of  shirt,  or  a  napkin.  The  triangular  bandage 
should  be  made  from  a  piece  36  to  40  inches  square,  by  folding 
this  square  diagonally  from  corner  to  corner,  thus  forming  two 
triangles ;  cutting  across  the  long  side  makes  two  triangular 
bandages. 

CRAVAT. 

The  triangular  bandage  may  be  used  in  two  forms — unfolded 
and  folded.  The  bandage  when  folded  is  known  as  a  cravat. 
This  is  made  by  bringing  the  point  or  apex  of  the  triangle  to 
the  middle  of  the  opposite  side  (the  base).  The  bandage  is 
again  divided  by  being  folded  lengthwise  along  a  line  midway 
between  the  base  and  the  new  top  of  the  bandage.  This  opera- 
38 


DRESSINGS.  39 

tion  is  repeated  until  the  width  desired  is  obtained.  The 
method  has  the  advantage  that  all  bandages  can  be  folded  to  a 
uniform  width.  To  complete  a  dressing  the  ends  of  the  bandage 
are  tied  together  securely.  Knots  should  be  placed  where  they 
do  not  cause  discomfort  and  where  they  may  be  easily  removed. 
The  reef  knot  (see  fig.  10)  is  the  one  recommended. 

BANDAGE  COMPRESS. 

A  bandage  compress  is  a  special  dressing,  which  may  be  of 
various  sizes,  to  cover  all  open  wounds.  It  consists  of  several 
thicknesses  of  sterile  gauze  sewed  to  the  middle  of  a  strip 
of  muslin.  Three  sizes  are  used — large,  medium,  and  small. 

ARM   SLING. 

Place  one  end  of  a  triangular  bandage  over  the  shoulder  of 
the  injured  side,  allowing  the  bandage  to  hang  down  in  front 
of  chest  so  that  the  apex  will  be  behind  the  elbow  of  the 
injured  arm;  bend  the  elbow  of  the  injured  arm  across  the 
chest,  thus  bringing  the  forearm  across  the  middle  of  the 
bandage.  Then  carry  the  lower  end  of  the  bandage  over  the 
shoulder  of  the  uninjured  side  and  tie  behind  the  neck.  Tuck 
the  apex  of  the  bandage  in  at  the  elbow. 

CRAVAT  SLING. 

In  making  a  cravat  sling  the  center  of  a  cravat  bandage,  suffi- 
ciently broad,  is  placed  under  the  injured  person's  wrist  and  part 
of  the  hand,  the  inner  end  passing  over  the  shoulder  of  the  in- 
jured side  and  the  other  end  passing  over  the  shoulder  of  the 
uninjured  side.  Tie  at  the  back  of  the  neck. 


40      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


TOURNIQUET. 

A  tourniquet  (figs.  8  and  9)  is  an  appliance  used  to  check 
severe  bleeding.  If  a  regularly  constructed  tourniquet  is  not  at 
hand,  one  can  be  improvised  from  a  strap,  belt,  suspenders,  a 

handkerchief,  a  towel,  band- 
age, necktie,  or  piece  of 
brattice  cloth.  A  tourniquet 
must  be  of  sufficient  length 
to  encircle  the  limb.  A  pad 
should  be  placed  over  the 
artery  or  vein  so  that  when 
the  tourniquet  is  tightened 
it  will  press  this  pad 
against  the  blood  vessel, 
thereby  stopping  the  flow 
of  blood.  The  pad  may  be 
made  from  a  smooth,  round 
stone,  a  cork,  a  piece  of 
coal,  a  knife,  or  some  object 
of  similar  shape  and  size 
covered  with  a  small  piece 
of  cloth,  so  that  it  will 
not  bruise  the  skin.  The 
tourniquet  should  be  passed 


\l 


FIGURE  8. — Tourniquet  applied  to  the 
arm. 


twice  around  the  limb  and 
tied  securely  at  the  outer 
side.  Make  two  more  knots  tied  loosely,  and  insert  a  stick 
between  the  last  two  knots  and  twist  until  the  bleeding  is 
stopped.  If  necessary,  a  cravat  bandage  may  be  looped  over 


DRESSINGS. 


the  end  of  the  stick  to  keep  it  from  untwisting  and  relieving 
the  pressure  of  the  pad  on  the  blood  vessel.  After  putting  the 
stick  into  the  loop  pull  it  away  from  the  body  when  twist- 
ing to  avoid  bruising  the  skin 
or  flesh.  A  tourniquet  should 
not  be  used  if  the  bleeding  can 
be  readily  checked  otherwise, 
because  it  stops  circulation  of 
blood  in  the  limb.  When  the 
circulation  of  the  blood  is  cut 
off  for  too  long  a  time,  death 
of  the  part  may  follow ;  there- 
fore, loosen  the  tourniquet  after 
it  has  been  in  place  20  minutes, 
but  do  not  remove  it.  If  bleed- 
ing does  not  start  again,  let 
the  tourniquet  remain  loose.  If 
bleeding  persists,  permit  the 
artery  to  spurt  five  or  six  times 
and  then  tighten  the  tourniquet 
again.  In  all  compound  frac- 
tures place  a  tourniquet  around 
the  injured  limb,  but  do  not 
tighten  it  unless  necessary.  If  spurting  blood  should  be  found 
when  handling  or  transporting  a  patient,  take  time  to  check  the 
bleeding. 

SPLINTS. 

Splints  are  used  for  broken  bones  and  suspected  broken  bones, 
to  prevent  them  from  moving  at  the  point  of  fracture,  and  at 


FIGURE 


|. — Tourniquet  applied  to 
the  thigh. 


42      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

the  nearest  joint.  They  must  be  of  stiff  material.  Improvised 
splints  may  be  made  from  pieces  of  wood,  broom,  pick  or  shovel 
handles,  mine  augers,  drills,  rules,  laths,  heavy  cardboard, 
canes,  umbrellas,  sprags,  cap  boards,  etc. 

In  making  a  splint  always  remember  that,  besides  being  firm 
and  stiff,  it  should  be  long  enough  to  prevent  movement  at  the 
joints  on  both  sides  of  the  fracture,  and,  if  possible,  be  as  wide 
as  the  thickness  of  the  limb  to  which  it  is  applied.  Splints 
should  be  well  padded  with  some  soft  material  on  the  inner 
side  and  at  the  ends  that  come  in  contact  with  the  body.  Cloth- 
ing sometimes,  when  not  removed  from  the  injured  part, 
answers  this  purpose. 

NEED  OF  CAREFUL,  BANDAGING. 

Bandage  firmly,  but  never  tightly.  A  tight  bandage  may  cut 
off  the  blood  supply  and  thereby  cause  death  of  the  parts.  In 
bandaging  an  arm  or  leg  leave  the  tips  of  the  fingers  or  toes 
uncovered  so  that  they  may  be  seen.  Always  place  the  part 
to  be  bandaged  in  the  position  in  which  it  is  to  be  left.  Re- 
member that  swelling  usually  follows  an  injury,  and  that  a 
tight  bandage  may  cause  death  of  the  part.  On  the  other 
hand,  do  not  make  a  bandage  too  loose,  as  it  may  slip  and 
expose  the  wound.  If  the  patient  complains  that  the  bandage 
is  too  tight,  loosen  it  and  make  it  comfortable,  but  snug. 
Never  apply  a  wet  bandage,  as  when  it  dries  it  expands  and 
becomes  too  loose. 

REEF  KNOT. 

Tie  a  single  knot.  Take  the  end  held  in  the  right  hand,  turn  it, 
and  allow  it  to  lie  parallel  to  the  bandage.  Then  take  the  end 


HEMORRHAGE  OR  BLEEDING. 


held  in  the  left  hand  and  cross  it  over,  around,  and  under  the 
end  that  has  been  turned  back;  then  put  it  through  the  loop 
formed   by    the    two    loose 
ends,  and  tie. 

HEMORRHAGE    OR 
BLEEDING. 

Hemorrhage  or  bleeding 
is  a  flow  of  blood  from  an 
artery,  vein,  or  capillary. 
When  bright  red  blood 
spurts  from  a  wound  an 
artery  has  been  cut.  If  the 
blood  is  red  and  oozes,  it 
is  from  capillaries.  When 
dark  red  blood  is  flowing 
in  a  steady  stream  it  is 
from  a  vein.  When  the 
blood  is  just  oozing  there 
is  no  cause  for  hurry  or 
alarm,  but  if  it  is  spurting  or  flowing  steadily  check  it  as 
quickly  as  possible,  for  the  patient  may  soon  be  beyond  aid  by 
reason  of  the  loss  of  blood. 

While  the  blood  is  flowing  through  the  body  it  is  fluid,  but 
as  soon  as  a  blood  vessel  is  severed  nature  provides  a  safeguard 
by  which  the  blood  thickens  or  clots  and  tends  to  stop  flowing. 
If  this  did  not  occur,  the  slightest  scratch  would  result  in  the 
loss  of  all  the  blood  in  the  body.  The  blood  of  some  persons 
will  not  clot.  They  are  called  "  bleeders,"  and  frequently  bleed 


FIGURE    10. — Reef  knot,   tightened  and 
loosened. 


44      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

to  death  from  a  slight  injury.  A  spouting  stream  of  blood  will 
not  clot.  This  is  one  reason  why  arterial  bleeding  is  so  danger- 
ous. In  order  to  clot,  the  blood  must  be  comparatively  at  rest. 
Pinching  the  blood  vessel  will  cause  a  clot  to  form,  as  will  a 
compress  applied  to  the  wound,  unless  there  is  severe  bleeding. 
Cover  the  wound  immediately  with  a  bandage  compress ;  an 
assistant  should  place  his  fingers  over  the  pressure  point  while 
the  tourniquet  is  being  prepared.  Never  use  cobwebs,  tobacco,  or 
waste  in  a  wound.  As  has  been  stated,  never  put  any  material 
over  a  wound  other  than  sterile  bandage  compress.  The  first- 
aid  man,  however,  is  advised  to  use  only  pressure,  position,  heat, 
or  cold.  Pressure  is  applied  by  the  fingers,  compresses,  tourni- 
quets, or  constricting  bands,  such  as  a  handkerchief,  belt  strap, 
strip  of  canvas,  or  suspenders.  Do  not  use  wire,  rope,  or  cord 
unless  unable  to  get  the  former. 

When  an  artery  is  bleeding  pressure  should  be  applied  be- 
tween the  wound  and  the  heart.  When  capillaries  are  cut  apply 
a  clean  compress  directly  over  the  injury.  When  a  vein  is 
bleeding  compression  should  be  made  on  the  side  of  the  wound 
away  from  the  heart.  Usually  bleeding  from  a  vein  can  be 
checked  by  applying  a  large  bandage  compress  directly  over 
the  bleeding  place.  Elevation  of  the  bleeding  parts  always  aids 
in  controlling  the  hemorrhage.  Place  the  person  in  such  a  po- 
sition that  he  will  be  least  affected  by  loss  of  blood.  Lay  him 
down  with  his  head  lowered  (unless  there  is  severe  bleeding 
from  the  head),  so  the  brain  will  get  as  much  blood  as  possi- 
ble. He  should  be  kept  at  rest,  as  violent  movements  of  the 
body  may  dislodge  the  clot.  Give  him  plenty  of  fresh  air,  and 
give  him  water  slowly  if  he  is  conscious.  Warm  him,  but  give 
him  no  stimulants  while  he  is  bleeding,  as  they  increase  the 


HEMORRHAGE  OR  BLEEDING.  45 

force  of  the  heart.  Avoid  their  use  as  much  as  possible  until 
bleeding  has  been  checked. 

PRESSURE    POINTS   TO    STOP   BLEEDING. 
i 

The  points  at  which  to  apply  pressure  to  stop  bleeding  are 

as  follows:  At  the  temple,  at  the  depression  back  of  the  center 
of  the  collar  bone,  at  a  point  on  the  arm  4  inches  below  the 
armpit  along  the  inner  seam  of  coat ;  at  the  bend  of  the  elbow, 
at  the  wrist,  at  the  thigh,  4  inches  below  the  groin  along  the 
inner  seam  of  trousers ;  under  the  knee,  and  at  the  ankle.  ( See 
fig.  5.) 

OPEN  WOUNDS. 

A  wound  may  be  denned  as  a  break  in  the  skin.  Wounds 
may  be  divided  into  four  kinds:  Incised,  lacerated,  contused, 
and  punctured.  Incised  wounds  are  produced  by  some  sharp 
cutting  instrument,  such  as  a  knife,  a  piece  of  glass,  or  a  piece 
of  sharp  coal,  slate,  or  stone.  The  edges  of  the  wound  are 
smoothly  divided  without  any  bruising  or  tearing.  Lacerated 
wounds  present  ragged  edges  and  are  the  result  of  tearing  the 
skin  and  tissues  by  blunt  instruments  or  machinery.  Contused 
wounds  are  those  in  which  the  skin  is  not  divided,  but  is  se- 
verely bruised.  Such  wounds  are  caused  by  heavy  blunt  instru- 
ments. Punctured  wounds  are  produced  by  pointed  instru- 
ments, such  as  needles,  splinters,  nails,  or  pieces  of  wire.  They 
are  usually  small  in  size,  but  .may  be  very  deep. 

The  chief  duty  of  a  first-aid  man  in  treating  a  wound  is  to 
prevent  germs  from  getting  into  it.  If  pus  germs  do  not  enter 
there  will  be  no  inflammation  and  the  parts  will  heal  quickly, 
but  should  such  germs  get  in  blood  poisoning  is  apt  to  follow. 
Rip  or  cut  the  clothing  so  that  the  injury  may  be  seen.  Do  not 


46      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

touch  the  wound  with  your  hand,  clothing,  or  any  instrument, 
and  do  not  pour  water  or  any  drugs  into  it.  Place  a  bandage 
compress  over  the  part  and  tie  it  in  place.  If  there  is  severe 
bleeding  always  check  it  first  by  »the  use  of  a  tourniquet.  Con- 
siderable shock  sometimes  follows  wounds,  especially  when 
much  blood  is  lost.  Do  not  forget  about  the  danger  of  leaving 
on  a  tourniquet  too  long.  (See  p.  41.) 

PRECAUTIONS    AGAINST    INFECTION    OF   WOUNDS. 

Germs,  which  are  minute  in  size  and  can  not  be  seen  by  the 
naked  eye,  often  get  into  wounds  and  cause  infection.  They 
are  found  everywhere — in  the  air,  on  the  clothing,  on  the 
surface  of  our  bodies,  on  our  hands  and  fingers,  in  our  mouths, 
in  dust,  in  water,  and  on  all  kinds  of  instruments  not  boiled, 
etc.  These  germs  may  irritate  the  tissues  and  destroy  them, 
or  they  may  get  into  the  circulation  and  cause  blood  poisoning. 
To  prevent  infection,  keep  your  hands,  clothing,  and  instru- 
ments away  from  the  wound.  Cover  it  with  a  bandage  com- 
press, and  leave  the  work  of  cleaning  the  wound  to  the  doctor. 

INTERNAL  HEMORRHAGE. 

Internal  hemorrhage  may  result  from  a  deep  wound  that 
cuts  large  blood  vessels  of  one  or  more  of  the  internal  organs 
or  from  bursting  internal  vessels.  In  internal  hemorrhage  the 
bleeding  may  not  be  seen,  but  you  may  be  able  to  determine  the 
condition  of  the  person  by  the  symptoms. 

Symptoms  of  internal  bleeding  are  faintness,  cold  skin,  pale 
face,  dilated  pupils,  thirst,  feeble  and  irregular  breathing, 
clouded  vision,  sighing,  weak  pulse,  dizziness,  and  later  loss  of 
consciousness.  The  severity  of  the  symptoms  depends  on  how 
much  and  how  rapidly  the  blood  is  lost. 


DRESSINGS  FOR  WOUNDS  AND  BLEEDING:  47 

Treatment. — Lay  the  patient  down,  with  his  head  lower  than 
his  body.  Apply  ice  or  cold  cloths  to  the  body  at  the  point 
from  which  you  think  the  bleeding  comes. 

Do  not  give  stimulants  unless  absolutely  necessary,  but  you 
may  give  ice  water  or  cold  water  slowly  if  the  patient  is  con- 
scious. Always  get  him  to  the  doctor  as  quickly  as  possible. 

DRESSINGS  FOB  WOUNDS  AND  BLEEDING. 
WOUND   AND   BLEEDING  OF   SCALP. 

1    A  wound  of  the  scalp  may  be  treated  by  placing  a  bandage 

compress  over  the  injury  carrying  the  ends  under  the  chin  and 

up  over  the  compress,   and   tying. 

Then   apply   a   triangular   bandage 

to   the   head,   having   the   base   fit 

over  the  forehead  snugly  just  over 

the  eyebrows.     Bring  the  two  ends 

of   the   bandage   around   the   head 

just  above  the  ears  and  cross  under 

the  bony  prominence  on  the  back 

of  the  head,  then  return  the  ends 

to  the  middle  of  the  forehead  and 

tie  just  above  the  eyebrows.     The 

apex  should  be  folded  at  the  back 

of    the    head    and    tucked    under. 

(See  fig.  11.) 

WOUND  AND  BLEEDING  OF  TEMPLE.    FlGUUE  "il.-Bandage    for   top 

Place  the  middle  of  a  bandage  pJ^^bl^^W°^ 
t compress  over  the  temple;  carry 

'one  end  under  the  chin  and  the  other  end  over  the  top  of  the 
head;    cross   the   ends   above   the   ear   on    the   opposite   side; 


48      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

carry  one  end  over  the  forehead  and  the  other  end  back  of 
the  head,  and  tie  over  the  compress.  Cover  the  compress  with 
a  cravat  bandage  applied  in  the  same  way.  (See  fig.  12.) 


FIGURE    12. — Dressing   for   wound   of   temple. 
WOUND   AND   BLEEDING   OF   FOREHEAD. 

A  wound  of  the  forehead  may  be  treated  by  applying  a  band- 
age compress  over  the  injury  and  holding  it  in  place  by  means 


DRESSINGS  FOR  WOUNDS  AND  BLEEDING. 


of  a  cravat  bandage  3  or  4  inches  wide.  Pass  the  ends  of  the 
bandage  compress  around  the  head,  crossing  them  behind  under 
the  bony  prominence,  bringing  them  forward,  and  tying  them 
in  front  over  the  wound. 
Apply  the  cravat  band- 
age in  a  similar  manner. 
(See  fig.  13.) 

WOUND    AND    BLEEDING 
OF  EYE. 

Foreign  bodies,  such 
as  particles  of  dirt,  sand, 
cinders,  coal,  emery  dust, 
or  fine  pieces  of  metal, 
are  frequently  blown  into 
the  eye  and  lodge  there. 
They  not  only  cause  a 
feeling  of  discomfort,  but „ 
if  not  removed  set  up 
an  inflammation  that  is 
painful  as  well  as  dan-  FlGURE  13.— Dressing  for  bleeding  and 
gerous.  Fortunately  na- 
ture through  an  increased  flow  of  tears  dislodges  most  of  these 
substances  before  any  harm  is  done.  In  no  case  should  the  eye 
be  rubbed,  as  such  a  procedure  is  apt  to  drive  any  foreign 
particles  deeper  into  the  tissues,  so  that  later  their  removal 
is  difficult.  If  the  foreign  body  lodges  under  the  upper  lid, 
it  may  sometimes  be  removed  by  drawing  the  upper  lid  down 
over  the  lower  lid,  and  as  the  upper  lid  returns  to  its  nor- 


50      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


mal  position  on  being  released  its  under  surface  will  be  drawn 

over  the  lashes  of  the  lower  lid  and  any  particles  will  be 

dislodged. 
Another  method  is  to  grasp  the  eyelashes  between  the  thumb 

and  forefinger  of  one  hand  and  turn  the  lid  up  over  the  tip 

of  the  finger  or  over  a 
match  or  a  pencil,  thus 
exposing  its  under  sur- 
face, from  which  any 
particle  may  be  care- 
fully removed  by  means 
of  a  corner  of  a  hand- 
kerchief or  a  camel's-hair 
brush. 

Particles  lodged  under 
the  lo\ver  lid  may  be  re- 
moved in  the  same  man- 
ner by  simply  pulling 
down  the  lower  lid  and 
exposing  the  inner  sur- 
face. 

Should  a  foreign  body 


FIGURE  14. — Dressing  for  wound  and 
bleeding  of  eye. 


become  lodged  on  the 
eyeball,  place  a  bandage 
compress  over  the  eye  and  hold  the  compress  in  place  with 
a  cravat  bandage  and  send  the  person  to  a  doctor  at  once. 
For  all  injuries  to  the  eye  a  bandage  compress  and  a  cravat 
bandage  should  be  used,  as  follows :  Place  a  bandage  compress 
over  the  eye,  carrying  the  ends  to  the  back  of  the  head  and 


DRESSINGS  FOR  WOUNDS  AND  BLEEDING. 


51 


tying;  hold  it  there  by  a  cravat  bandage  3  inches  wide,  ap- 
plied as  follows :  Place  the  middle  of  the  bandage  over  the 
injured  eye,  passing  the  end  on  the  injured  side  below  the 
ear  to  the  back  of 
the  head  and  passing 
the  other  end  above 
the  ear  on  the  oppo- 
site side  and  tie  in  a 
single  knot  below  the 
bony  prominence  on 
the  back  of  the  head. 
Bring  both  ends  over 
the  top  of  the  head, 
p  a,s  s  i  n  g  the  longer 
end  under  the  band- 
age, raising  it  above 
the  uninjured  eye  and 
then  tying  it  to  the 
other  end.  (See  fig. 
14.) 


WOUND    AND    BLEED- 
ING   OF    NOSE. 


FIGURE  15. — Dressing  for  wound  or  fracture 
of  nose. 


For  a  wound  of  the 
nose  split  the  tails  of 

a   bandage   compress.    Then   apply   the  pad  of   the   compress 
to  the  wound,  passing  the  ends  of  the  bandage  above  and  be- 
low the  ears  on  each  side  and  tying  them  back  of  the  head. 
51607° — 17 5 


52      ADVANCED  FIKST-AID  INSTRUCTIONS  FOR  MINERS. 


Usually  nose  bleeding  is  of  small  consequence,  but  it  may  en- 
danger life.  The  person  should  be  in  a  sitting  position,  with  the 

head  thrown  slightly 
back.  Apply  ice  or 
cold  water  to  back  of 
head,  bridge  of  nose, 
and  forehead.  Have 
him  avoid  blowing  of 
the  nose  for  several 
hours.  If  these  meas- 
ures fail  call  a  physi- 
cian. (See  fig.  15.) 

WOUND  AND  BLEED- 
ING OF  FACE  OR 
CHIN. 

Split  the  tails  of  a 
bandage  compress  and 
apply  the  compress  to 
the  wound,  passing  the 
ends  above  and  below 
the  ears  on  each  side, 
and  tying  them  back  of 
the  head.  (See  fig.  16.) 

WOUND  AND  BLEEDING  OF  NECK  OR  THROAT. 

If  bleeding  of  neck  or  throat  is  severe,  it  may  be  checked  by 
pressure  of  the  fingers  wrapped  with  gauze  or  clean  cloth  and 
placed  directly  in  the  wound.  Later  cover  with  a  bandage 
compress,  tying  it  loosely. 


FIGURE  16. — Dressing  for  wound  or  bleeding 
of  chin  or  face. 


DRESSINGS  FOR  WOUNDS  AND  BLEEDING. 


53 


WOUND  AND  BLEEDING  OF  EAR. 

Apply  the  pad  of  a  bandage  compress  behind  and  over  the 
ear,  passing  the  ends  around  the  head,  crossing  them  above  the 
opposite  ear,  bringing  them  back  over  the  pad  and  tying  them. 
(See  fig.  17.)  If  bleeding  is  severe,  pass  a  cravat  bandage 
around  the  head  as 
directed  for  dressing 
bleeding  from  temple. 
(See  fig.  12.) 

WOUND   AND   BLEED- 
ING OF  SHOULDER. 

For  bleeding  and 
wound  of  shoulder 
place  a  bandage  com- 
press  directly  over 
the  wound,  bring  the 
ends  under  the  arm- 
pit, and  cross  and  tie 
them  under  the  oppo- 
site armpit.  Cover  . 
with  a  triangular 
bandage,  along  the  FlGURE  17— Dressing  for  wound  of  ear' 
base  of  which  a  hem  has  been  folded,  as  follows:  Place  apex 
high  up  on  shoulder,  place  the  base  below  the  shoulder  on 
the  upper  part  of  the  arm,  and  carry  the  ends  around  the 
arm  and  tie  them  on  the  outside.  To  hold  the  apex  in  place 
take  a  cravat  bandage,  and  place  its  center  over  the  apex  of 
the  triangular  bandage,  and  carry  the  ends  to  the  opposite 


54      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


armpit    and    tie   them.     Tuck    the    apex    over   bandage.     (See 
fig.  18.)     The  forearm  should  be  placed  in  a  sling  made  of  a 

cravat  bandage  (sling  not  shown  in  the 

figure ) . 

WOUND  AND  BLEEDING  OF  ARMPIT. 

Apply  bandage  compress  over  wound, 
crossing  the  ends  over  shoulder  and 
tying  under  opposite  arm.  If  the  hem- 
orrhage is  severe,  over  the  compress 
place  some  hard  material,  about  the 
size  of  an  egg,  such  as  a  piece  of 
coal,  stone,  or  wood,  covered  with  cloth, 
and  push  it  well  up  into  the  armpit, 
holding  it  in  place  by  a  cravat  band- 
age, the  center  of  which  is  placed  over 
the  hard  material,  the  ends  being 
brought  over  the  shoulder  and  tied  in 

FIGURE  18. Dressing  for   a    single    knot.     Then    pass    the    ends 

wound  and  bleeding  of  around   and   tie   them  under  the  oppo- 

shoulder.  site  armpit.     Then  bring  the  arm  down 

and  secure  it  firmly  to  the   chest  wall  by   a  cravat  bandage 

passed   around   the  arm   and   chest   and   tied   securely   on   the 

opposite  side.     Place  forearm  in  sling.     (See  fig.  19.) 

ARM  TORN  FROM  BODY. 

When  an  arm  has  been  torn  from  the  body  at  the  socket  there 
is  profuse  bleeding  from  the  larger  blood  vessels  which  are 


DRESSINGS  FOR  WOUNDS  AND  BLEEDING. 


55 


torn;  therefore  treatment  should  be  prompt.  Cover  your  hand 
thoroughly  with  gauze,  if  it  is  available,  and  pass  the  hand 
right  up  into  the  wound  and  pinch  the  blood  vessels.  Then  pack 
the  wound  with  gauze  and  bandage  firmly.  However,  if  there 
is  no  gauze  at  hand,  do  not  wait,  but  place  your  fingers  in  the 
wound  and  pinch  the  blood  vessels. 
While  doing  this  have  an  assistant 
prepare  gauze,  and  when  ready  let 
go  of  vessels,  push  the  gauze  firmly 
into  the  wound,  and  bandage.  Place 
a  bandage  compress  over  the  seat  of 
the  injury,  passing  the  ends  around 
the  chest  and  back  and  tying  se- 
curely under  the  opposite  arm. 
Then  apply  a  cravat  bandage  about 
6  inches  wide  over  this  bandage 
compress,  the  ends  crossing  the  chest 
and  back,  and  tie  under  the  arm  f^. 
on  the  opposite  side. 


FIGURE    19.  —  Dressing 
wound  of  armpit. 


WOUND  AND  BLEEDING  OF  ARM. 


Apply  the  pad  of  a  bandage  compress 
over  the  wound,  passing  the  ends 
around  the  arm  and  tying  them  over 
the  pad.  Cover  this  with  a  cravat  bandage  of  sufficient  width  to 
cover  the  wound,  pass  the  extremities  around  the  arm,  and  tie 
them  on  the  outer  side  of  the  arm.  For  severe  bleeding  from  any 
part  of  the  arm,  except  the  wrist,  press  the  artery  on  the 
inner  side  of  the  arm  against  the  bone  at  a  point  just  behind  the 


56      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

inner  border  of  the  large  muscle  of  the  arm  that  corresponds 
to  the  seam  of  the  coat  sleeve,  apply 
a  tourniquet,  not  forgetting  to  use  the 
pad,    and    cover    the    wound    with    a 
bandage  compress.    ( See  fig.  20. )    Place 
the    forearm    across 
the    chest    and    hold 
it   in    place    with    a 
triangular  bandage. 

WOUND  AND  BLEED- 
ING OF  ELBOW. 

Place  a  bandage 
compress  over  the 
wound  and  tie  it  in 
place.  Cover  with 
cravat  bandage  of 
the  desired  width,  as 
follows :  Place  the 
center  over  the  point 
of  the  elbow,  pass 
ends  around  and 
cross  them  at  the 
bend  of  the  elbow, 
crossing  them  again 

FIGURE  20.— Dressings  FIGURE  21.— Dressings  above  the  point  of 
for  wounds  of  arm  for  wounds  of  elbow  the  elbow,  carrying 
and  forearm.  and  wrist.  them  around  the 

arm  and  tying  them  at  the  outer  side  below  the  point  of  the 

elbow.     (See  fig.  21.) 


DRESSINGS  FOR  WOUNDS  AND  BLEEDING.  57 

WOUND  AND  BLEEDING  OF  FOREARM  OR  WRIST. 

Place  a  bandage  compress  over  the  wound  and  tie  it  firmly  in 
place.  Then  apply  a  cravat  bandage  of  proper  width,  as  fol- 
lows: Place  the  center  of  the  cravat  over  the  pad,  carry  both 
ends  around  the  forearm,  bringing  them  around  the  second  time 
and  tying  them  on  the  outer  side  over  the  wound.  If  this  dress- 
ing does  not  control  the  bleeding,  put  some  hard  material  about 
the  size  of  a  small  egg  well  wrapped  in  gauze  or  cloth  in  the 
bend  of  the  elbow  and  bend  the  forearm  tightly  against  it, 
bandaging  in  this  position  by  placing  the  middle  of  a  cravat 
bandage  on  the  outer  side  of  the  arm,  passing  twice  around  arm 
and  forearm,  between  elbow  and  wrist,  near  the  latter,  and 
tying  on  the  outside,  or  apply  tourniquet  as  for  bleeding  of  arm. 

If  there  is  bleeding  at  the  wrist,  place  a  bandage  compress 
directly  over  the  wound  and  tie.  Then  pass  a  cravat  bandage 
several  times  around  the  wrist,  tying  the  ends  securely  over 
the  seat  of  the  injury.  If  this  does  not  control  the  bleeding, 
apply  dressing  directed  for  bleeding  of  arm  or  forearm.  (See 
figs.  20  and  21.) 

WOUND  AND  BLEEDING  OF  BACK  OF  HAND. 

Apply  a  bandage  compress  over  the  wound  and  tie  it  firmly 
in  place.  Cover  with  a  triangular  bandage,  as  follows:  Place 
the  base  on  the  inner  side  of  the  wrist,  bringing  the  apex  down 
over  the  palm  of  the  hand ;  returning  it  around  the  tips  of  the 
fingers,  over  the  back  of  the  hand  to  a  point  above  the  wrist ; 
cross  the  ends  one  on  either  side  of  the  wrist  and  bring  them 
to  the  forearm  and  tie  them  on  the  back  of  the  wrist;  bring 
the  apex  down  over  the  knot  and  tuck  it  under.  For  severe 


58      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


bleeding  from  the  hand  alone,  first  cover  the  wound  with  a 
bandage  compress.  Pressure  should  then  be  made  on  the  ves- 
sels at  the  wrist  in  the  following  manner :  Tie  twro  knots  in  the 
middle  of  a  cravat  bandage  about  a  quarter  of  an  inch  apart 
and  place  them  over  the  vessels  on  the 
palm  side  of  the  wrist,  the  bandage  passing 
around  the  wrist  several  times ;  then  tie 
the  ends  securely  over  the  knots.  Use  a 
triangular  sling  to  hold  the  forearm  across 
the  chest.  (See  fig.  22.) 


WOUND     AND 


BLEEDING 
HAND. 


OF     PALM      OF 


Place  a  bandage  compress  over  the  wound 
and  tie  it  firmly  in  place.  Cover  with  a 
cravat  bandage,  as  follows :  Place  the 
around  the  wrist  and  across  the  palm,  bring- 
one  end  between  the  thumb  and  the  fore- 
finger and  the  other  end  around  the  little- 
finger  side  of  the  hand,  and  cross  the  ends 
at  the  back  of  the  hand ;  bring  the  ends 
around  the  wrist  and  across  the  palm, bring- 
FIGURE  22. — Dressing  ing  one  end  between  the  thumb  and  the 

Jfrhrn°dnd  °f  baCk   forefinSer  and  the  other  on  the  little-finger 
side,  crossing  the  ends  on  the  back  of  the 

hand  and  passing  them  around  the  wrist  and  tying  them  on  the 
back  of  the  wrist.  (See  fig.  23.)  In  severe  bleeding  from  the 
palm  of  the  hand,  place  a  bandage  compress  over  the  wound  and 
tie  it  securely.  Then  place  a  piece  of  coal  or  similar  hard 


DRESSINGS  FOR  WOUNDS  AND  BLEEDING. 


59 


object  wrapped  in  gauze  over  the  compress,  and  fold  the  pa- 


tient's lingers  over  the  object, 
about    2    inches    wide    and 
place  over  the  patient's  fin- 
gers,   carrying   the   ends   of 


Take  the  middle  of  a  cravat 


FIGURE  23.  —  Dressing 
for  wound  of  palm  of 
hand. 


FIGURE    24. — Dressing   for   wound    of 
finger. 


the  bandage  to  the  back  of  the  patient's  hand,  cross  them  and 
bring  them  over  his  fingers,  cross  them  and  bring  them  to  back 
of  hand,  cross  them  again  and  bring  them  to  wrist,  and  tie  on 
back  of  wrist. 


60      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


WOUND  AND  BLEEDING  OF  FINGER. 

Place  a  small  bandage  compress  over  the  wound  and  tie  it 
firmly  in  place  by  wrapping  the  ends  around  the  finger.    Where 

a  number  of  fingers 
are  badly  injured  ap- 
ply a  small  bandage 
compress  to  each  fin- 
ger as  directed  above, 
then  apply  open  tri- 
angular bandage  as 
directed  for  a  wound 
of  the  hand.  (See 
fig.  24.) 


WOUND  AND  BLEED- 
ING OF  SIDE  OF 
CHEST. 

Apply  a  bandage 
compress  over  the 
wound  and  tie  firmly 
in  place.  Cover  with 
triangular  bandage 
as  follows :  Place 
the  base  diagonally 
across  the  chest,  the 
upper  end  passing 
FIGURE  25. — Dressing  for  wound  of  side  of  chest,  over  the  shoulder 
and  down  the  back ;  tie  the  apex  and  lower  end  at  center  of 
back;  tie  the  end  coming  over  the  shoulder  also  at  this  place. 
(See  fig.  25.) 


DRESSINGS  FOR  WOUNDS  AND  BLEEDING. 


61 


WOUND  AND  BLEEDING  OF  ABDOMEN. 

Apply  a  bandage  compress  over  the  wound  and  tie  it  in  place. 
Place  the  center  of  the  base  of  a  triangular  bandage  on  the 
upper  part  of  the  abdomen,  carry 
both  ends  around  the  body  and 
tie  them  on  the  back,  bring  the 
apex  between  the  legs,  and  tie  all 
the  ends  at  the  back.  ( See  fig.  26. ) 

WOUND    AND    BLEEDING    BE- 
TWEEN  SHOULDERS. 

Apply  a  bandage  compress  over 
the  wound  and  tie  the  ends  to 
hold  the  compress  firmly  in  place. 
Cover  the  compress  and  shoulders 
with  a  triangular  bandage  as  fol- 
lows: Place  the  center  of  the 
base  back  of  the  neck,  allowing 
the  apex  to  drop  down  between 
the  shoulders ;  carry  the  ends 
over  the  shoulders  and  under 
the  armpits  and  around  the  back, 
and  tie  a  knot  over  the  apex ;  turn  apex  up  and  tuck  it  under 
the  knot.  (See  fig.  27.) 

WOUND  AND  BLEEDING  OF  BACK. 

For  a  wound  of  the  upper  part  of  the  side  of  the  back  apply 
a  bandage  compress  held  in  place  by  having  the  ends  passed 


FIGURE    26. — D  r  e  s  s  i  n  g 
wound    of    abdomen. 


62      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

around  the  body  and  tied.  Cover  this  with  a  triangular  band- 
age, the  base  of  which  is  placed  diagonally  across  the  back,  one 
end  passing  over  the  right  shoulder.  Bring  the  two  lower  ends 


FIGURE  27. — Dressing  for  wound  between  shoulders.     Reverse  dressing 
for  wound  of  center  of  chest. 

together  in  front  of  the  body  and  tie.  Tie  the  end  passing  over 
the  shoulder  in  the  same  place.  Apply  a  similar  bandage  witl) 
the  upper  end  passing  over  the  left  shoulder.  (See  fig.  54,  p.  99.) 


DRESSINGS  FOR  WOUNDS  AND  BLEEDING. 


63 


For  a  wound  and  bleeding  of  the  lower  part  of  the  back  or 
the  buttocks  apply  a  bandage  compress  over  the  wound,  holding 
it  in  place  by  passing  the  ends  around  the  body  and  tying  them. 
Cover  the  compress  with  a  triangular  bandage,  as  follows :  Place 
the  center  of  the  base  in  the  middle  of  the  back,  tying  the  two  long 
ends  in  a  single  knot  in  front,  pull  the 
apex  forward  through  the  crotch,  and 
tie  it  to  the  ends  in  front.  ( See  fig.  28. ) 

WOUND  AND  BLEEDING  OF  GROIN. 

Place  a  bandage  compress  over  the 
wound,  carry  the  ends  to  the  hip, 
cross  them  and  carry  them  across  to 
the  opposite  side  of  the  body  and  tie 
them.  Apply  the  middle  of  the  base 
of  a  triangular  bandage  to  the  inner 
part  of  the  thigh  about  4  inches  below 
the  groin,  with  its  apex  toward  the 
knee,  and  secure  the  bandage  by  tying 
the  ends.  The  apex  should  be  carried 
far  up  on  the  abdomen  and  held  in  posi- 
tion by  a  cravat  bandage  passed  around 
the  body  and  tied.  The  apex  should 
then  be  tucked  around  the  knot.  (See  fig.  29.)  To  control 
arterial  bleeding  at  this  point  where  the  body  joins  with  the  ex- 
tremities, tie  the  ends  of  two  cravat  bandages.  Place  the  knot 
over  a  bandage  compress  placed  over  the  wound.  Carry  one 
end  to  top  of  hip  and  other  end  between  legs,  cross  ends  at  point 
of  hip  on  injured  side,  carry  them  around  the  body  and  tie  then? 
in  front. 


FIGURE  28. — Dressing  for 
wound  of  lower  part  of 
back. 


G4      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


WOUND  AND  BLEEDING  OF  HIP. 

Place  a  bandage  compress  over  the  wound  and  tie  it  in  place. 
Cover  it  with  a  triangular  bandage,  as  follows :  Place  the  base 
well  up  on  the  thigh  with  the  apex  pointing  toward  the  armpit, 

bring  the  ends  around  the 
thigh,  and  tie.  Pass  a 
cravat  bandage  around 
the  body  and  tie  a  knot 
over  the  apex,  tucking 
the  apex  over  the  knot. 
(See  fig.  30.) 

WOUND   AND   BLEEDING 
OF  THIGH. 

Apply  a  bandage  com- 
press to  the  wound  and 
tie  it  firmly  in  place. 
Cover  the  compress  with 
a  triangular  bandage,  the 
center  of  the  base  of 
which  is  placed  over  the 
thigh  far  up,  the  ends 
being  passed  around  the 
thigh,  crossed,  and  tied 
above  the  knee.  Bring  the 
apex  up  and  tuck  it  over 
FIGURE  29. — Dressing  for  wound  of  groin.  ^Q  knot.  (See  fig.  31.) 

Severe  bleeding  from  the  thigh  may  be  checked  by  making  pres- 
sure with  the  fingers  placed  four  finger  breadths  below  the  fold 
of  the  groin,  at  a  point  over  which  the  inner  seam  of  the  trouser 
leg  would  pass.  Then  place  roll  or  pad  over  the  part  and  apply  a 


DRESSINGS  FOR  WOUNDS  AND  BLEEDING. 


65 


tourniquet.  ( See  "  Tourniquet,"  p.  40. )  Now  place  a  bandage 
compress  over  the  wound  and  keep  in  place  by  a  triangular  band- 
age as  described  for  wound  of  thigh. 

WOUND     AND     BLEEDING     OF 
KNEE. 

Place    a    bandage    compress 
over    the    wound    and    tie    it 


FIGURE  30. — Dressing  for  wound  of    FIGURE  31. — Dressing  for  wound 

hip.  of  thigh. 

firmly  in  place.     Fold  a  broad  hem  along  the  base  of  a  tri- 
angular bandage  for  a  covering  and  place  the  center  below 


66      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

the  knee,  the  apex  resting  above  the  knee.  Bring  the  ends  of 
the  bandage  around  either  side  of  the  leg,  cross  them  at  the  back 
of  the  knee,  pull  them  forward,  and  tie  them  above  the  knee. 
Pull  the  apex  down  and  tuck  it  around  the  knot.  (See  fig.  32.) 
For  severe  bleeding  of  the  knee  cover 
the  wound  with  a  bandage  compress  and 
either  apply  a  tourniquet  as  directed 
for  severe  bleeding  of  the  thigh  or  place 
a  pad  about  the  size  of  a  goose  egg 
in  the  bend  of  the  knee,  bend  the  joint 
on  it,  and  bandage  the  leg  in  this 
position  by  passing  a  cravat  bandage 
around  the  ankle  and  the  upper  part 
of  the  thigh. 

BLEEDING    FROM    VARICOSE    VEINS    IN 
THE  LEG. 

Varicose    veins    are    enlarged    veins, 
which    are   usually    found    in    the    leg; 

V-  W  oftentimes  the  least  exertion  may  cause 

^f  them  to  burst,  and  serious  results  may 

follow.     Lay  the  person  down  and  ele- 
FIGURE  32.— Dressing  for   vate  the  leg.     Rip  or  cut  tight  clothing, 
wound  of  knee.  bands,  etc.,  from  around  the  leg  so  that 

the    injury    may    be    seen.     Apply    a    bandage    compress    over 
the  bleeding  point  and  bandage  it  firmly  into  place. 

WOUND  AND  BLEEDING  OF  LEG. 

Apply  a  bandage  compress  over  the  wound  and  hold  it  firmly 
in  place  by  applying  a  cravat  bandage  over  this  dressing, 
placing  the  center  over  the  compress.  Then  pass  the  ends 


DRESSINGS  FOR  WOUNDS  AND  BLEEDING. 


67 


around  the  leg,  one  on  each  side,  several  times  and  tie  on  either 
side  of  the  shin  bone.  ( See  fig.  33. )  For  severe  bleeding  of  the 
leg,  apply  a  tourniquet  as  directed  for  severe  bleeding  of  the 
thigh,  and  cover  wound  as  described 
above. 

WOUND   AND    BLEEDING    OF   ANKLE    OR 
HEEL. 

Place  a  bandage  compress  over  the 
wound  and  tie  it  firmly  in  place.  Cover 
this  dressing  with  a  broad  cravat  band- 
age, the  center  of  which  should  be  placed 
over  the  heel.  Bring  the  ends  to  the 
top  of  the  foot  and  cross  them,  one  pass- 
ing around  the  foot  at  the  instep  and 
the  other  passing  around  the  ankle  just 
above  the  heel,  cross  them  over  the  in- 
step, bring  them  around  the  sole  of  the 
foot,  and  tie  them  on  top  of  the  instep. 
In  severe  bleeding  at  the  ankle,  place  a 
bandage  compress  over  the  wound  and  FlGURE  33-  —  Dressing 
tie  it  firmly  in  place.  If  this  does  not 

check  the  bleeding,  apply  a  tourniquet,  making  pressure  on 
a  pad  placed  over  the  blood  vessel  just  behind  the  inner  side 
of  the  ankle  bone.  Apply  a  cravat  bandage  over  the  compress, 
as  follows:  Place  a  cravat  bandage  about  3  inches  wide  over 
the  pad  of  a  bandage  compress,  bring  the  ends  over  the  instep, 
cross  them,  and  pass  them  around  the  foot,  tying  them  on  top 
of  the  foot.  Care  should  be  taken  not  to  cover  the  tourniquet. 
(See  fig.  34.) 

51G070— 17 6 


68      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


WOUND  AND  BLEEDING  OF  FOOT. 

Apply  a  bandage  compress  to  the  wound  and  tie  it  firmly  in 
place.  Cover  this  with  an  open  triangular  bandage  in  the  fol- 
lowing manner :  Place  the  base  of  the  triangle  on  the  back  of 
the  ankle  and  bring  the  apex  under  the  sole  of  the  foot,  over 
the  toes,  back  over  the  instep  and  up  the  leg  to  a  point  above 
the  ankle  in  front;  then  pass  the 
ends  around  the  ankle  to  the  front 
and  tie.  Fold  the  apex  around  the 
knot.  To  check  arterial  bleeding 
place  a  pad 
about  the 
size  of  a 
small  egg  on 
either  side 
of  the  ankle 
below  the 
ankle  bones, 
holding  it  in 
position  with 
a  cravat 
b  a  n  d  a  g  e  . 
(See  fig.  35.) 


FIGURE   34.  —  Dressing   for 
wound  of  ankle  or  heel. 


FIGURE  35. — Dressing  for 
wound  of  foot  or  toe. 


WOUND  AND  BLEEDING  OF  FOOT  OR  ANKLE. 

Apply  a  bandage  compress  to  the  wound  and  place  the 
center  of  a  cravat  bandage  folded  wide  over  the  instep,  cross 
the  ends  under  the  sole  of  the  foot,  and  bring  them  up  and 
across  over  the  instep,  passing  them  around  the  back  of  the 


FOREIGN  BODIES  IN  THE  EAR. 


ankle  and  tying  them  in  front.     In   case  of  severe  bleeding 
check  it  as  in  bleeding  from  the  foot     (See  fig.  36.) 

WOUND  AND  BLEEDING  OF  TOE. 

Place  a  small  bandage  compress  over  the  toe  and  tie  it 
firmly  in  place.  If  several  toes  are  injured,  apply  a  small 
bandage  compress  to  each  toe  and  tie  se- 
curely. Then  apply  a  triangular  bandage 
as  follows :  Place  the  base  of  the  triangle  on 
the  back  of  the  ankle  and  bring  the  apex 
under  the  sole  of  the  foot,  over  the  toes 
and  the  instep,  and  up  the  leg  to  a  point 
above  the  ankle  in  front;  then  bring  the 
ends  around  the  ankle  to  the  front  and  tie 
them.  Fold  the  apex  around  the  knot.  For 
severe  bleeding  a  compress  firmly  tied  about 
the  toe  will  check  the  flow  of  blood.  ( See  fig. 
35.) 

FOREIGN   BODIES   IN   EAR. 

Small  insects,  as  ants,  flies,  or  bugs,  or  FIGURE  36. — Dress- 
pieces  of  coal,  may  gain  access  to  the  ear.  ing  for  wound  of 
Other  bodies,  as  corn,  peas,  buttons,  or  small  foot  or  ankle-. 
seeds  are  often  introduced  into  the  ears  by  children.  Such  sub- 
stances as  seeds  absorb  moisture  and  are  thus  dangerous  as  they 
swell  up  after  entering  the  ear,  making  dislodgment  difficult, 
and  they  often  produce  a  painful  inflammation. 

The  only  instrument  that  should  be  employed  by  one  unskilled 
in  such  work  is  the  syringe.  On  no  account  should  pins  or  pieces 
of  wire  be  inserted  into  the  ear  to  dislodge  a  foreign  body.  In- 
sects may  be  killed  by  dropping  a  little  sweet  oil  into  the  ear 


70      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

and  then  may  be  removed  by  syringing  the  ear  with  warm  water. 
To  remove  seeds,  water  should  not  be  used,  but  some  liquid  like 
dilute  alcohol,  which  will  cause  the  seed  body  to  shrink,  should 
be  employed.  If  the  syringe  fails,  attempt  nothing  more,  but 
obtain  medical  aid. 

FOREIGN   BODIES   IN   NOSE. 

Foreign  bodies  rarely  need  remain  long  in  the  nose,  as  violent 
sneezing,  induced  by  snuff  or  irritation  of  the  opposite  nos- 
tril, will  generally  dislodge  them.  Violent  blowing  of  the  nose 
with  one  nostril  closed  may  dislodge  a  foreign  body.  Should 
the  means  mentioned  fail,  consult  a  doctor. 

FOREIGN  BODIES  IN  WINDPIPE  OB  THROAT. 

Pins,  coins,  needles,  fishbones,  false  teeth,  and  particles  of 
food  often  become  lodged  in  the  windpipe  or  the  throat.  Al- 
though there  is  not,  as  a  rule,  a  complete  obstruction  of  the  air 
passages,  symptoms  of  suffocation  more  or  less  severe  are  pres- 
ent, the  victim's  face  becomes  livid,  he  gasps  for  breath,  and  he 
has  violent  fits  of  coughing. 

Particles  of  food  are  frequently  sucked  into  the  windpipe  by 
a.  sudden  inspiration  while  eating ;  hence  a  person  should  be 
careful  not  to  laugh  while  he  has  anything  in  his  mouth. 

In  all  cases  an  attempt  should  immediately  be  made  to  remove 
the  obstruction.  Frequently  by  simply  passing  a  finger  into  the 
throat  the  body  may  be  felt  and  easily  removed.  Substances 
deeper  down  can  not  be  felt  in  this  way,  but  may  be  dislodged  by 
producing  coughing  or  by  slapping  the  person  on  the  back.  If  this 
means  fails,  the  patient  should  be  inverted,  or  literally  stood  on 
his  head,  with  the  hope  of  dislodging  the  substance.  If  still 


BRUISES.  71 

unsuccessful,  send  immediately  for  a  physician.  In  the  mean- 
time, if  there  is  danger  of  the  person  choking,  perform  artificial 
respiration. 

FOREIGN   BODIES   IN   STOMACH. 

Children,  adults,  or  insane  persons  sometimes  swallow  pins, 
coins,  nails,  etc.  The  article  swallowed  may  be  lodged  in  the 
tube  leading  to  the  stomach,  producing  difficulty  in  swallowing, 
but  more  often  it  passes  on  into  the  stomach  and  appears  later 
in  a  passage  of  the  bowels. 

It  is  dangerous  to  attempt  to  dislodge  the  foreign  body  from 
the  stomach  by  producing  vomiting.  Avoid  also  giving  purga- 
tives, as  they  cause  an  increased  movement  of  the  bowels,  and 
in  the  case  of  a  pin  or  sharp  object  a  hole  in  the  bowels  may 
result. 

The  best  plan  is  to  consult  a  physician  immediately. 

BRUISES. 

Bruises  are  the  most  common  injuries  and  are  due  to  a  fall 
or  a  blow.  When  a  person  falls  and  strikes  some  part  of  the 
body,  or  is  struck  by  something,  often  the  skin  is  not  broken, 
but  the  force  of  the  blow  or  fall  injures  the  tissues  under  the 
skin,  breaking  many  of  the  small  blood  vessels.  In  deep  bruises 
the  outer  skin  is  not  damaged,  but  the  skin  over  the  bone  is  apt 
to  show  a  black-and-blue  spot.  If  a  larger  blood  vessel  is  in- 
jured much  blood  gathers  under  the  skin,  causing  great  swelling 
and  discoloration. 

The  symptoms  are  immediate  pain  from  injury  to  the  nerves, 
swelling,  black-and-blue  mark,  and  later  pain  from  pressure  of 
the  blood  on  the  nerves,  which  is  increased  by  movement. 


72      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

Little  treatment  is  necessary.  The  aim  should  be  to  limit 
swelling  and  to  decrease  pain.  Apply  an  ice  bag  or  towels 
wrung  out  in  cold  water  and  rest  the  injured  part  as  this  dimin- 
ishes the  pain.  Always  make  sure  that  there  is  no  other  injury, 
such  as  a  broken  bone  or  a  dislocation.  For  a  severe  bruise  it 
is  best  to  call  a  physician. 

STRAINS. 

A  strain  means  overstretching  of  the  muscles.  The  most 
common  strains  are  those  of  the  back,  shoulder,  ankle,  and  wrist. 
A  strain  may  be  caused  by  a  sudden  wrench,  as  in  lifting  heavy 
weights.  In  severe  strains  small  blood  vessels  may  be  broken 
so  that  blood  escapes  into  the  muscles. 

The  injured  man  should  be  made  to  rest  for  a  time.  Rub  the 
parts  gently  with  alcohol  and  water  or  witch  hazel  to  deaden 
the  pain.  If  the  strain  is  severe  the  patient  should  consult  a 
physician. 

SPRAINS, 

A  sprain  means  an  injury  to  a  joint.  It  results  from  violent 
stretching,  twisting,  or  partial  breaking  of  ligaments  about  a 
joint,  and  is  often  mistaken  for  a  fracture  of  the  bones.  Twist- 
ing of  the  foot  or  an  unnatural  movement  of  a  joint  may  cause 
a  sprain. 

The  injured  joint  should  be  elevated  and  placed  at  absolute 
rest,  as  often  a  sprain  is  accompanied  by  a  fracture.  Apply  hot 
or  cold  towels  over  the  injury  several  times.  Place  a  cravat 
bandage  firmly  around  the  joint  and  send  the  injured  man  to 
the  doctor. 


DISLOCATIONS.  73 

DISLOCATIONS. 

A  dislocation  is  a  slipping  of  a  bone  out  of  its  socket.  The 
ligaments  are  always  torn,  except  where  the  patient  has  suf- 
fered many  dislocations  at  the  point  of  injury,  in  which  case 
the  ligaments  are  stretched  and  free  from  injury.  The  shoulder 
joint  is  the  one  most  frequently  dislocated,  but  the  hip  joint 
and  the  fingers  are  often  dislocated.  You  can  always  tell  a  dis- 
location by  comparing  the  injured  with  the  uninjured  side  of 
the  body,  as  a  deformity  will  appear  on  the  injured  side,  and 
you  can  usually  feel  the  head  of  the  bone.  The  limb  in  which 
the  joint  is  located  may  be  either  longer  or  shorter  than  the 
uninjured  limb.  It  is  impossible  to  place  the  limb  in  its  natural 
position.  The  injured  person  will  suffer  pain  and  sometimes 
there  will  be  swelling  and  shock. 

Do  not  attempt  to  reduce  the  dislocation  unless  it  is  a  simple 
one,  as  of  a  finger  or  the  lower  jaw.  In  attempting  reduction 
of  other  dislocations  you  might  destroy  blood  vessels,  ligaments, 
etc.  Apply  dressings  or  splints  in  the  line  of  deformity. 

DISLOCATION  OF  LOWER  JAW. 

A  dislocated  jaw  is  painful.  The  mouth  is  open  and  the  jaw 
is  rigid  and  can  not  be  closed.  To  reduce  this  dislocation  both 
thumbs  must  first  be  wrapped  in  several  layers  of  cloth,  so  that 
they  will  not  be  liable  to  injury.  Then  place  the  thumbs  in 
the  injured  person's  mouth,  resting  them  on  his  lower  teeth  well 
back  on  each  side,  while  the  fingers  seize  the  lower  jaw  outside. 
Press  first  downward  and  thdn  backward.  As  soon  as  the  jaw 
starts  into  place  the  thumbs  should  be  slipped  off  the  teeth  to  the 
inside  of  the  cheeks,  so  they  will  not  be  caught  between  the 


74      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


teeth   when   the   jaw   springs   into   place.     A   cravat   bandage 
should  be  placed  over  the  front  of  the  chin  and  tied  at  the 

back  of  the  head,  the 
ends  being  left  long. 
Have  the  patient  open 
his  mouth  and  place 
a  bandage  compress, 
lead  pencil,  or  like  ob- 
ject between  the  teeth 
to  prevent  the  nexl 
bandage  from  being 
placed  too  tightly. 
Take  another  cravat 
bandage,  placing  its 
center  under  the  pa- 
tient's chin,  and  bring 
the  ends  to  the  center 
of  the  top  of  the  head 
and  tie,  leaving  the 
ends  long.  Then  tie 
the  ends  of  both  cra- 
vats. Now  remove  the 
wedging  object  from 
between  the  patient's 
teeth.  (See  fig.  37.) 
FIGURE  ST.-Dressing  for  dislocation  or  frac-  The  patient  should 


ture  of  lower  jaw. 


consult   a   doctor. 


DISLOCATION    OF    SHOULDER. 

The  shoulder  joint  is  dislocated  more  frequently  than  any 
other  joint  in  the  body.  This  injury  may  be  produced  by  falls 
or  blows  on  the  shoulder  or  by  falls  on  the  hand  or  elbow. 


DISLOCATIONS. 


75 


With  this  dislocation  the  arm  is  held  rigid,  the  elbow  stands; 
off  a  distance  of  1  or  2  inches  from  the  body,  the  shoulder  ap- 
pears flat,  and  there  is 
a  marked  depression  be- 
neath the  point  of  the 
shoulder.  In  addition, 
there  is  pain  and  swell- 
ing at  the  seat  of  the 
injury.  By  placing  the 
fingers  in  the  armpit 
the  head  of  the  bone 
may  be  felt  in  an  ab- 
normal position  as  com- 
pared to  the  uninjured 
side.  The  injured  man 
will  be  unable  to  bring 
the  elbow  of  the  injured 
side  in  contact  with  the 
chest  when  the  palm 
of  the  hand  of  the 
injured  side  is  placed 
near  the  top  of  the  op- 
posite shoulder. 

Place  the  hand  on  the 


FIGURE    38. — Dressing    for    dislocation 
shoulder. 


injured  side  on  the  op- 
posite side  of  the  chest 
and  hold  it  in  this  posi- 
tion by  means  of  a  cravat  sling  tied  around  the  neck.  A 
large  pad,  made  from  a  coat  or  jumper,  should  be  placed 
under  the  arm,  from  the  armpit  to  the  elbow,  so  that  the 


76      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

elbow  will  be  held  away  from  the  side  of  the  body.  The  cen- 
ter of  a  cravat  bandage  is  then  applied  just  above  the  elbow 
and  carried  around  the  body ;  the  end  in  front  crosses  the 
forearm  and  runs  below  the  wrist  and  is  tied  on  the  opposite 
side.  Another  cravat  bandage,  the  center  of  which  is  placed 
below  the  pad,  is  passed  over  the  forearm  and  around  the  back 
and  tied  on  the  opposite  shoulder.  ( See  fig.  38. ) 

DISLOCATION   OF  ELBOW. 

Dislocation  occurs  at  the  elbow  joint  as  a  result  of  a  direct 
force  or  blow  at  the  joint,  also  occasionally  by  a  fall  on  the  hand. 
It  can  usually  be  recognized  by  deformity  at  the  joint,  great 
pain,  and  inability  to  bend  the  limb  at  the  joint.  It  should  be 
treated  as  for  fracture  of  the  elbow  (see  p.  84). 

DISLOCATION  OF  FINGER. 

To  treat  a  dislocated  finger,  grasp  the  hand,  with  the  back 
upward,  then  pull  the  end  of  the  finger  straight  out  away  from 
the  hand  and  the  bone  will  usually  slip  into  place.  No  bandage 
Is  required.  Do  not  attempt  reduction  if  there  is  an  open  wound 
near  the  joint. 

DISLOCATION    OF   KNEE    OR    KNEECAP. 

Dislocation  of  the  knee  or  the  kneecap  occurs  as  a  result  of 
direct  force  applied  at  the  knee  or  from  a  fall  on  the  knee. 
There  are  the  usual  signs  of  deformity,  great  pain,  and  inability 
to  use  the  knee.  It  should  be  treated  as  for  fracture  of  the 
kneecap,  care  being  taken  not  to  tie  the  cravats  too  tightly  over 
the  knee. 


DISLOCATIONS.  77 

DISLOCATION  OF  HIP. 

Dislocation  of  the  hip  is  usually  the  result  of  a  fall  from  a 
height  onto  the  foot  or  knee,  or  may  be  caused  by  a  direct  blow, 
with  the  thigh  at  an  angle  with  the  spine.  There  are  several 
varieties,  described  according  to  the  direction  the  head  of  the 
thigh  takes,  but  for  all  practical  purposes  they  may  be  divided 
into  forward  and  backward  dislocations.  A  backward  dislocation 
is  by  far  the  most  common.  In  either  kind  of  dislocation  the 
limb  is  held  rigid  and  the  pain  is  marked.  In  a  forward  dis- 
location the  thigh  is  somewhat  flexed  and  held  outward,  the 
foot  being  also  turned  out.  The  limb  may  be  either  lengthened 
or  shortened.  In  a  backward  dislocation  the  foot  is  turned  in- 
ward and  the  thigh  is  drawn  toward  or  across  tke  opposite  limb. 
Shortening  of  the  limb  is  also  marked. 

Place  the  injured  person  on  a  board  about  12  inches  wide  and 
7  feet  long  or  on  a  framework  similar  to  that  used  in  dressing  a 
broken  back.  (See  p.  89.)  If  there  is  no  shock,  support  the 
patient's  head  on  a  pillow  made  of  clothing.  Make  a  large  pad 
of  clothing  or  blankets  of  sufficient  size  to  support  the  limb  in  the 
line  of  deformity.  Place  a  small  pad  between  the  feet.  Pass  a 
cravat  bandage  around  the  board  and  the  upper  part  of  the  chest, 
on  which  a  small  pad  should  be  placed.  Then  tie  the  ends  of  the 
bandage  over  the  pad.  Pass  a  second  cravat  bandage  around  the 
board  and  the  body  at  the  hips,  tying  the  ends  over  a  small  pad 
in  front.  Pass  a  third  bandage  around  the  board  and  the  thigh 
just  above  the  knees  and  tie  on  the  injured  side  near  the  board. 
Another  bandage  should  be  passed  around  the  ankles  and  the 
board  and  tied  near  the  board  on  the  injured  side.  Take  an- 
other cravat  bandage,  place  the  center  over  the  insteps,  cross 


78      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

the  ends  under  the  soles  of  the  feet,  and  bring  them  back  to  the 
insteps,  tying  loosely.     (See  fig.  39.) 


FIGURE  39. — Dressing  for  dislocation  of  hip. 
FRACTURES. 

Fracture  means  the  breaking  of  a  bone.  For  practical  pur- 
poses in  first-aid  work  only  two  kinds  of  fracture  are  handled — 
simple  and  compound.  These  fractures  are  further  divided  into 
greenstick,  comminuted,  impacted,  transverse,  and  oblique,  de- 
pending on  the  way  in  which  the  bone  is  broken.  A  simple 
fracture  is  one  in  which  the  bone  is  broken  but  does  not  break 
the  skin.  In  a  compound  fracture  there  is  a  wound  in  the 
skin  communicating  with  the  bone.  A  simple  fracture  may 
be  converted  into  a  compound  fracture  by  careless  handling, 
as  a  broken  bone  usually  has  sharp,  saw-tooth  edges,  arid  just  a 
little  twist  may  push  it  through  the  skin.  A  person  handling 
a  fracture  must  always  bear  this  danger  in  mind. 

You  will  recognize  a  fracture  by  the  following  signs:  The 
person  will  complain  of  pain  and  tenderness  at  the  point  of 
fracture  and  may  be  unable  to  move  the  broken  limb ;  in  han- 
dling the  limb  a  grating  sensation  may  be  felt,  but  do  not  twist 
a  limb  in  order  to  produce  this  grating  sound ;  also,  the  limb 
will  be  either  shortened  or  bent  as  compared  with  a  similar 


FRACTURES.  79 

part  on  the  uninjured  side.  A  person  suffering  from  a  fracture 
may  be  able  to  move  his  toes  and  fingers.  Shock  may  be  present 
to  a  greater  or  less  degree,  so  treat  accordingly.  If  the  injured 
person  is  lying  down,  leave  him  where  he  is  until  you  have 
made  a  thorough  examination,  and  do  your  splinting,  if  possible, 
before  he  changes  his  position.  In  a  simple  fracture  there  is 
no  chance  for  germs  to  get  into  the  break,  as  there  is  no  wound 
in  the  skin ;  but  if  there  is  an  opening  from  the  outside,  there 
is  an  avenue  of  infection  that  is  dangerous,  so  be  careful  not  to 
convert  a  simple  fracture  into  a  compound  one.  If  the  fracture 
is  a  simple  one,  place  the  limb  in  a  position  as  nearly  natural 
as  possible  by  taking  hold  of  the  lower  part  of  the  limb  and  pull- 
ing gently  and  steadily.  At  the  same  time  an  assistant  should 
support  the  under  part  of  the  limb  on  either  side  of  the  break 
in  order  to  steady  the  bone.  If  the  bone  is  protruding,  cover 
it  with  a  bandage  compress,  but  do  not  attempt  to  pull  the  limb, 
but  place  it  in  a  position  as  nearly  normal  as  possible  before 
applying  splints.  These  should  be  applied  as  for  a  simple  frac- 
ture. 

FRACTURE  OF   SKULL. 

Fracture  of  the  skull  means  a  break  in  the  bone  or  bones  of 
the  top,  side,  or  back  of  the  head.  The  injured  person  may  or 
may  not  be  unconscious.  If  the  base  of  the  skull  is  broken, 
blood  and  serum  (a  liquidlike  water)  may  flow  from  the  ears. 
Bleeding  may  be  noticed  in  the  eyes,  nose,  and  mouth.  Usually.  , 
if  there  is  an  open  wound,  you  will  find  severe  bleeding.  Check 
the  bleeding  by  placing  a  bandage  compress  over  the  wound  and 
tying  it  firmly  in  place.  Do  not  put  much  pressure  on  this 
wound,  as  it  may  force  the  broken  bones  into  the  brain;  how- 


80      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

ever,  some  pressure  must  be  made.  Fracture  may  be  present 
and  still  no  wound  be  in  evidence.  Apply  a  triangular  bandage 
as  described  for  treatment  of  wounds  of  the  head.  Do  not  give 
stimulants  if  the  man  is  bleeding,  but  keep  him  warm.  Rest  his 
head  by  placing  it  on  a  folded  blanket  or  coat.  This  should 
always  be  done  in  injuries  to  the  head  and  in  sunstroke.  Shock 
is  usually  present.  (See  fig.  11.) 

FRACTURE  OF   NOSE. 

This  fracture  is  usually  not  difficult  to  detect.  It  may  be 
simple  or  compound.  Symptoms :  Pain,  bleeding,  swelling,  and 
deformity. 

Apply  a  bandage  compress  with  the  pad  over  the  nose.  Split 
the  tails,  passing  the  upper  pair  over  the  ears  and  tying  them 
back  of  the  head ;  pass  the  lower  pair  around  below  the  ears 
and  tie  them  on  the  back  of  the  neck.  This  dressing  should  not 
be  applied  so  tightly  that  it  will  cause  too  much  pressure  on  the 
nose.  Send  the  patient  to  the  doctor  at  once.  (See  fig.  17.) 

FRACTURE  OF  UPPER  JAW  OR  CHEEK  BONE. 

In  fractures  of  the  upper  jaw  or  the  cheek  bone,  where  there 
are  open  wounds,  treat  as  for  wounds  of  the  face.  (See  p.  52.) 

FRACTURE  OF  LOWER  JAW. 

In  fracture  of  the  lower  jaw  the  mouth  is  usually  open  and 
the  patient  generally  has  difficulty  in  talking.  Place  the  center 
of  a  cravat  bandage  over  the  chin  and  pass  the  ends  around  to 
the  back  of  the  neck  and  tie.  Another  cravat  bandage,  the 
center  of  which  is  placed  under  the  chin,  is  taken  to  the  top  of 


FRACTURES. 


8f 


the  head  and  tied,  the  ends  of  the  upper  and  lower  bandages 
being  then  tied  together  firmly.  (See  fig.  37.) 

FRACTURE  OF  COL- 
LAR BONE. 

Take  a  cravat 
bandage  about  4 
inches  wide,  and 
place  the  center 
over  a  pad  on  the 
point  of  the  shoul- 
der ;  bring  one  end 
over  the  shoulder 
and  one  under  the 
armpit  to  the  cen- 
ter of  the  back. 
Apply  a  similar 
bandage  over  a 
pad  on  the  oppo- 
site shoulder* 
draw  all  ends  I 
tight,  pulling  the\ 
shoulders  well 
back  and  tie  the 
ends  in  the  center  FlGURE  40-~Dressin^fc0kr^reawcture  °f  collar  bone' 
of  the  back.  The 

forearm  on  the  injured  side  is  carried  across  the  chest  at  right 
angles  to  the  body  and  held  in  position  by  a  sling  made  from 
an  open  triangular  bandage.  (See  figs.  40  and  41.) 


82      ADVANCED  FIKST-AID  INSTRUCTIONS  FOE  MINERS. 


If /ft  I 


/ 


FIGURE  41. — Dressing  for  fracture  of  collar  bone,  front  view. 


FRACTURES.  83 

FRACTURE  OF  SHOULDER  BLADE. 

This  is  not  a  common  injury.  The  fracture  is  usually  caused 
by  direct  violence.  The  usual  signs  and  symptoms  of  a  frac- 
ture— pain,  swelling,  and  disability — are  present,  but  there  may 
be  some  difficulty  in  locating  the  exact  seat  of  the  injury. 

Fractures  of  the  shoulder  blade  are  best  treated  by  a  large 
bandage  compress  over  the  seat  of  the  injury,  one  end  of  the  tail 
being  crossed  back  under  the  opposite  arm,  the  other  end  being 
placed  across  the  chest  and  carried  under  the  opposite  arm,  the 
two  ends  of  the  tail  being  tied  over  the  compress.  Place  the 
forearm  at  right  angles  to  the  body  and  hold  it  in  place  by  a 
sling  made  from  a  triangular  bandage. 

FRACTURE   OF    ARM. 

Fracture  of  the  arm  refers  to  fracture  of  the  bone  leading 
from  the  elbow  to  the  shoulder,  and  can  be  easily  recognized  by 
the  usual  signs — pain,  swelling,  deformity,  etc.  Also,  the  in- 
jured person  may  be  unable  to  move  his  arm. 

Straighten  the  limb  by  taking  hold  of  it  on  either  side  of  the 
fracture  and  putting  it  in  a  position  as  natural  as  possible. 
Use  two  splints  of  unequal  length,  well  padded.  They  should 
preferably  be  4  inches  wide  and  one-quarter  inch  thick.  Place 
the  shorter  one  on  the  inner  side  of  the  arm,  extending  from  the 
armpit  to  the  elbow ;  place  the  other  and  longer  one  on  the  outer 
side  of  the  arm,  extending  from  the  point  of  the  shoulder  to 
the  elbow.  Pass  one  cravat  bandage  around  the  splints  and 
the  arm  at  the  upper  end  and  tie  on  the  outside,  and  an- 
other at  the  lower  end  and  tie  on  the  outside.  Then  fold  a 
triangular  bandage  into  a  cravat  and  use  as  an  arm  sling.  If 
there  is  a  compound  fracture,  first  place  a  bandage  compress 
51607°— 17 7 


84      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


over  the  wound  and  tie  it  in  place ;  then  apply  dressings  as  sug- 
gested. If  a  bone  is  protruding  apply  a  bandage  compress 
lightly  so  as  not  to  force  the  bone  into  the  tissues.  If  an  artery 

is  bleeding  and  the  band- 
age compress  does  not 
check  the  hemorrhage, 
apply  a  tourniquet.  ( See 
fig.  42.) 

FRACTURE  OF  ELBOW. 

Tie  or  nail  two  boards 
together,  forming  an 
L -shaped  splint.  The 
boards  should  preferably 
be  4  inches  wide  and 
one-quarter  inch  thick. 
One  board  should  reach 
from  the  armpit  to  the 
elbow,  the  other  from 
the  elbow  to  the  tips 
of  the  fingers.  Pad  the 
splint  well  and  place  it 
on  the  inner  side  of  the 
arm  and  the  forearm. 

Pass  one  cravat  band- 
FIGURE  42. — Dressing  for  fracture  of  arm.    age    around     the    upper 

end  of  the  arm  and  the 

splint  and  tie  on  the  outside ;  pass  a  second  cravat  bandage 
around  the  splint  and  the  arm  just  above  elbow,  crossing 
it  in  front  of  the  bend  of  the  elbow  and  then  carry  it  around 


FRACTURES. 


85 


the  forearm  and  the  splint,  cross  in  back,  and  bring  the  ends 
to  the  front  and  tie  on  the  outside;  pass  a  third  cravat 
around  the  splint  and  the  wrist,  bring  bandage  up  to  wrist, 
cross  at  the  back  of  the  hand,  bringing  one  end  between  the 
thumb  and  the  forefinger 
and  the  other  end  over  the 
little -finger  side  of  the 
hand,  crossing  at  the  palm ; 
bring  the  ends  around  the 
wrist,  and  tie.  Support 
the  forearm  in  a  sling 
made  from  a  cravat  band- 
age. (See  fig.  43.) 

FRACTURE  OF  FOREARM. 

Fracture  of  the  forearm 
means  the  breaking  of 
either  one  or  both  bones 
leading  from  the  elbow  to 
the  wrist.  As  in  fracture 
of  the  arm,  you  can  easily 
detect  a  broken  bone  or 
bones  at  this  point.  In 
applying  a  splint  always 
have  the  patient's  hand 
extended  and  his  thumb 
pointing  upward.  The  assistant  should  hold  the  bones  on 
either  side  of  the  fracture.  In  treating  a  fracture  of  the  fore- 
arm use  two  splints  3  or  4  inches  wide,  one-quarter  inch  thick, 
and  of  unequal  length,  one  being  long  enough  to  extend  from 


FIGURE   43. — Dressing  for  fracture  of 
elbow. 


ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


the  bend  of  the  elbow  to  the  hand,  so  as  to  cover  all  but  the  last 
joints  of  the  fingers,  and  the  other  long  enough  to  extend  from 
the  elbow  to  the  first  joints  of  the  fingers.  Pad  the  splints  and 

place  them  in  position. 
Use  three  cravat  band- 
ages to  hold  the  splints  in 
place.  Place  the  center 
of  the  first  cravat  on  the 
outer  splint  as  close  to 
the  elbow  as  possible; 
wrap  the  ends  around 
the  forearm  two  or  three 
times,  and  tie  on  the  out- 
side. Place  the  second 
cravat  bandage  in  the 
center  of  the  forearm 
and  apply  in  the  same 
manner.  Place  the  third 
cravat  over  the  outside 
splint,  bring  it  around 
the  wrist,  cross  on  the 
back  of  the  hand,  pass  one 
end  between  the  thumb 
and  the  forefinger  and 
the  other  end  around  the 
little-finger  side,  across 
the  palm,  and  around  the 
hand  between  the  thumb 
and  the  forefinger,  and 
tie  the  two  ends  on  the  back  of  the  hand.  Use  a  cravat  sling. 
In  case  of  a  compound  fracture,  first  apply  a  bandage  com- 
press to  the  wound  and  tie  the  bandage  firmly  in  place;  then 
apply  splints.  (See  fig.  44.) 


FIGURE    44. — Dressing    for    fracture 
forearm. 


FRACTURES. 


87 


FRACTURE  OF  WRIST. 

For  a  fracture  of  the  wrist  use  the  same  dressings  and  splints 
as  described  for  fracture  of  the  forearm. 

FRACTURE  OF  BONES  OF  HAND. 

Prepare  two  splints  of  a  length  to  reach  from  just  above  the 
wrist  to  the  tips  of  the  fingers ;  pad  each  splint  thoroughly,  the 
part  of  the  pad  that  is 
placed  in  the  palm  being 
somewhat  thicker  than  the 
rest.  Fasten  the  splints 
with  a  cravat  bandage. 
Place  the  middle  of  the 
cravat  over  the  splint  on 
the  inner  side  of  wrist, 
pass  the  ends  around  the 
wrist,  crossing  them  on 
the  back  of  the  hand,  and 
pass  them  around  the 
hand  and  the  splint,  one 
side  passing  between  the 
thumb  and  the  forefinger, 
cross  them  on  the  palm 
side,  and  bring  them  to 
the  back  and  tie.  Use  a 
cravat  sling. 

In  case  there  is  a  com-     FIGURE   45.— Dressing  for  fracture  of 
pound    fracture    of    these 

bones,  place  a  bandage  compress  over  the  wound  and  tie  firmly 
in  place.     Then  apply  splints.     (See  fig.  45.) 


88      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


FRACTURE   OF  FINGER. 

The  usual  symptoms  of  fracture  are  present — pain,  swelling, 
and  deformity.     Put  a  narrow  padded  splint  under  the  broken 

finger  and  hold  it  in  place 
with  a  narrow  strip  torn 
from  a  triangular  band- 
age. Support  the  hand  in 
a  narrow  sling.  If  there 
is  a  compound  fracture, 
apply  a  small  bandage 
compress  to  the  wound ; 
then  apply  splints  as  sug- 
gested above. 

FRACTURE   OF  RIB. 

The  fracture  of  a  rib 
is  usually  caused  by  a 
direct  blow  or  severe 
squeezing  and  can  occur 
at  any  point  along  its 
length.  Symptoms  are 
severe  pain  on  breathing, 
tenderness  over  the  sus- 
pected fracture,  inability 
to  take  a  long  breath  on 
account  of  pain  pro- 
duced. In  a  thin  person  the  fracture  can  be  seen  under- 
neath the  skin.  Oftentimes  grating  can  be  felt  by  placing 
the  hand  over  the  seat  of  the  injury.  If  the  lung  of  a  person 


FIGURE  46. — Dressing  for  broken  ribs. 


FRACTURES.  89 

Buffering  from  a  fractured  rib  has  been  punctured,  he  may  cough 
up  blood. 

Locate  the  fracture,  then  place  the  center  of  one  broad  cravat 
bandage  over  that  point  and  carry  the  ends  around  the  body  and 
tie  a  half  knot  loosely.  Then  have  the  patient  expel  the  air  from 
his  lungs.  As  this  is  being  done,  pull  the  two  ends  to  tighten 
the  bandage,  and  tie.  Use  at  least  three  wide  cravat  bandages. 
Under  each  knot  place  a  pad  so  that  the  skin  will  not  be  bruised. 
When  the  dressing  has  been  properly  applied  the  patient  will 
breathe  with  less  strain.  ( See  fig.  46. ) 

FRACTURE  OF  SPINE. 

A  broken  back  may  be  recognized  by  the  patient  being  unable 
to  move  his  legs ;  in  fact,  he  will  have  complete  paralysis  from 
the  waistline  down.  Deformity  will  be  present  at  the  point 
where  the  spine  has  been  fractured. 

If  the  patient's  back  is  bent,  do  not  try  to  straighten  him ;  if 
he  can  not  be  placed  in  a  straight  position  without  pain  or 
without  force,  send  for  the  doctor.  If  his  back  is  straight, 
use  2  long  splints,  3  short  splints,  and  13  cravat  bandages. 
The  long  splints  should  be  of  sufficient  length  to  reach  from 
a  point  about  8  inches  above  the  head  to  8  inches  below  the 
heel,  and  they  should  be  at  least  1  inch  thick  and  4  inches  wide. 
The  short  splints  should  be  15  to  18  inches  long  and  at  least  1 
inch  thick.  Have  a  space  of  2  or  3  inches  between  the  long 
splints. 

Place  the  first  short  splint  at  a  point  corresponding  to  the 
shoulders  of  the  patient.  The  second  short  splint  should  be  placed 
at  a  point  corresponding  to  the  patient's  hips.  The  third  short 
splint  should  be  placed  at  a  point  corresponding  to  his  ankles. 


90      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

Fasten  these  cross  splints  securely  to  the  long  splints  with  cravat 
bandages,  wire,  or  nails.  Pad  each  long  splint  well  with  blankets, 
canvas,  or  clothing.  Have  four  men  kneel,  three  on  one  side  and 
one  on  the  opposite  side,  each  man  kneeling  on  the  knee  nearest 
patient's  feet.  They  should  gently  lift  him  at  the  word  of  com- 
mand. Then  slip  the  prepared  splint  under  him  and  have  the 
men>  gently  lower  the  patient  onto  the  splint.  If  no  shock  is 
present,  use  a  folded  coat  or  blanket  for  a  pillow  under  the 
head.  See  that  the  backbone  is  between  the  long  splints.  Tie 
the  body  to  the  splints  with  13  cravats  as  follows : 

Pass  the  first  cravat  around  the  splints  and  the  body  just 
head.     See  that  the  backbone  is  between  the  long  splints.     Tie 


FIGURE  47. — Dressing  for  broken  back,  front  view. 

chest ;  pass  a  second  cravat  around  the  splints  and  the  back  and 
carry  the  ends  over  the  lower  part  of  the  chest,  tying  them  in 
front  over  a  pad ;  pass  the  third  cravat  around  the  splints  and 
the  patient's  hips,  tying  in  front;  pass  the  fourth  cravat  over 
one  shoulder  to  the  inner  side  of  a  long  splint,  crossing  the 
sJaort  splint ;  carry  it  forward  under  the  armpit  on  the  same 
.side:  of  the  body,  tying  the  ends  in  front  a  little  below  the 
shoulder ;  pass  the  fifth  cravat  in  a  similar  manner  around 
the;  ;0ther  shoulder ;  pass  the  sixth  cravat  around  one  hip, 
across  both  short  and  long  splints  on  one  side,  and  forward 


FRACTURES. 


91 


in  the  crotch,  and  tie  the  ends  in  front ;  apply  the  seventh  cravat 
in  a  similar  manner  around  the  other  hip ;  pass  the  eighth  cravat 
around  the  splint  and  the  upper  part  of  one  thigh,  tying  the  ends 
on  the  outer  side ;  apply  the  ninth  cravat  in  a  similar  manner  on 
the  other  thigh ;  pass  the  tenth  cravat  around  the  long  splint  and 
one  leg  below  the  knee,  and  tie  on  the  outer  side;  apply  the 
eleventh  cravat  in  a  similar  manner  around  the  other  leg ;  pass 
the  twelfth  cravat  around  the  long  splint  and  one  leg  at  the 
ankle,  and  tie  on  the  outer  side ;  appl  y  the  thirteenth  cravat  in  a 
similar  manner  around  the  other  ankle.  Cover  the  patient  with 


FIGURE  48. — Dressing  for  broken  back,  rear  view. 

blankets  and  treat  for  shock.    The  splint  prepared  as  described 
will  serve  as  a  stretcher.     (See  figs.  47  and  48.) 

FRACTURE  OF  PELVIS  OR  HAUNCH  BONE. 

Fracture  of  the  pelvis  occurs  as  a  result  of  a  squeeze  through 
the  hips  or  of  a  direct  blow.  The  break  most  frequently  occurs 
in  front  and  along  the  midline  of  the  body  where  the  two  sides 
of  the  pelvis  join.  Much  importance  is  attached  to  the  injury 
for  the  reason  that  it  is  so  frequently  accompanied  by  rupture 


92      ADVANCED  FIRST-AID  INSTRUCTIONS  FOB,  MINERS. 

of  the  bladder,  which  lies  just  behind  the  bones  that  make  up 
the  front  wall  of  the  pelvis.  The  symptoms  of  this  fracture  are 
not  easily  detected.  Therefore  when  the  injured  person  com- 
plains of  great  pain  through  the  pelvis,  it  is  well  to  keep  him 
lying  flat  on  his  back.  Pass  a  bandage  at  least  6  inches  wide 
around  his  pelvis  and  tie  it  tight  to  prevent  movement  of  frac- 
tured parts.  (This*  bandage  is  not  shown  in  fig.  49.)  He  should 
be  placed  on  a  broken-back  splint  or  a  board  about  7  feet  long, 
12  inches  wide,  and  1  inch  thick.  A  pad  or  a  padded  splint  ex- 
tending from  the  chest  to  the  abdomen  should  also  be  used.  If  a 
broken-back  splint  is  used,  pass  a  cravat  bandage  3  inches  wide 


FIGURE  49. — Dressing  for  fracture  of  pelvis  or  haunch  bones.  Flat 
board  or  framework  7  feet  long,  12  inches  wide,  and  1  inch  thick 
may  also  be  used. 

around  the  upper  part  of  each  thigh  and  tie  on  the  outer  side ; 
place  a  cravat  bandage  around  each  splint  and  each  leg  just  be- 
low the  knees  and  tie  the  ends  on  the  outer  side  over  the  splint. 
Place  another  cravat  bandage  around  the  ankle  of  each  leg  and 
splint  and  tie  on  the  outer  side.  Pass  another  cravat  bandage 
over  the  upper  part  of  the  chest  and  tie  over  the  pad  in  the 
center  of  the  chest.  Pass  another  cravat  bandage  at  the  lower 
part  of  the  chest  and  tie  on  the  center  of  the  chest  over  the  pad. 
Pass  another  cravat  bandage  over  hips  and  tie  in  center  over 
pad.  (See  fig.  49.)  If  a  board  instead  of  a  broken-back  splint 


FRACTURES.  93 

is  used,  instead  of  bandaging  each  leg  separately,  the  three 
lower  bandages  should  be  passed  over  both  legs  and  be  tied 
near  the  board  on  the  injured  side.  Treat  the  patient  for  shock 
and  get  him  to  the  doctor  or  a  hospital  without  delay,  for  in 
rupture  of  the  bladder  it  is  only  in  the  first  hour  or  two  that 
an  operation  gives  any  hope  of  success. 

FRACTURE   OF   THIGH. 

Fractures  of  the  hip  or  the  thigh  are  usually  caused  by  direct 
or  indirect  violence.  They  may  be  caused  by  a  fall  on  the  leg. 
Such  fractures  occur  frequently  with  old  people.  The  bone 
may  be  broken  anywhere  along  its  length. 

The  signs  of  fracture  are  pain,  swelling,  deformity,  shorten- 
ing, etc.  Practically  every  person  with  such  a  fracture  is  un- 
able to  move  the  limb.  Usually  the  foot  will  be  turned  outward. 
This  injury  is  often  mistaken  for  a  dislocation  of  the  hip.  The 
person  may  suffer  from  shock. 

Use  two  splints,  4  inches  wide  and  one-fourth  inch  thick,  one 
reaching  from  the  armpit  to  1  inch  below  the  heel,  the  other 
reaching  from  the  crotch  to  1  inch  below  the  heel.  Pad  well 
and  use  extra  padding  near  bony  prominences.  While  an  as- 
sistant is  gently  pulling  the  limb  into  a  position  as  nearly  nor- 
mal as  possible  the  broken  bones  should  be  supported  by  plac- 
ing the  hands  underneath  on  each  side  of  the  break.  Use  seven 
cravat  bandages.  Apply  the  first  bandage  above  the  seat  of  the 
fracture.  Place  the  next  bandage  below  the  seat  of  the  frac- 
ture. Place  the  third  cravat  below  the  knee.  Place  the  fourth 
bandage  above  the  ankle.  Place  the  fifth  bandage  around  the 
upper  part  of  the  chest  and  back,  and  the  sixth  bandage  around 
the  body  at  the  lower  part  of  the  chest.  Place  the  final  bandage 


94      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

around  the  body  at  the  hips.     Tie  all  knots  on  the  outer  edge 
of  the  splint.     ( See  fig.  50. ) 

To  place  these  bandages  fold  the  cravat  bandage  at  its  center 
over  the  end  of  a  thin  splint  and  by  means  of  this  splint  push 
the  bandage  under  the  body  or  limb.  All  body  bandages  should 
be  pushed  under  the  body  at  the  small  of  the  back  and  the 
bandage  slid  up  or  down  to  its  proper  position.  In  a  similar 
manner  bandages  to  be  placed  around  the  leg  should  be  pushed 
under  the  leg  at  the  knee  and  then  slid  up  or  down  to  their 
proper  positions.  There  are"  arches  or  curves  in  the  body  at 
these  two  points  and  consequently  bandages  can  be  pushed 


FIGURE  50. — Dressing  for  fracture  of  thigh. 


through  at  these  places  without  moving  the  patient  or  causing 
him  discomfort. 

The  injured  and  the  uninjured  limbs  should  not  be  bound 
together  in  dressing  this  fracture.  If  the  uninjured  leg  is  left 
free,  the  patient  can  move  or  shift  himself  with  the  uninjured 
leg  when  his  position  becomes  uncomfortable.  However,  when 
the  patient  is  to  be  transported  on  a  stretcher  out  of  mine,  his 
feet  should  be  tied  together. 

Never  place  a  bandage  over  point  of  fracture.  It  may  be 
nece'ssary  to  change  the  position  of  these  bandages  according 
to  the  extent  of  the  injury.  Treat  for  shock. 


FRACTURES. 


FRACTURE   OF   KNEECAP. 


95 


Fracture  of  the  kneecap  is  caused  by  a  direct  or  indirect  blow, 
or  by  muscular  action.  It  can  be  easily  recognized  by  the 
following  symptoms:  Pain,  swelling,  and  deformity;  usually  a 
groove  or  separation  is  felt  in  the  kneecap. 

Straighten  the  limb.  If  shock  is  present,  treat  it.  Prepare 
a  splint  4  inches  wide,  i  inch  thick,  and  of  sufficient  length  to 
extend  from  the  middle  of  the  thigh  to  1  inch  beyond  the  heel ; 
pad  thoroughly,  placing  extra  padding  under  the  knee,  above 
the  heel,  and  at  the  upper  end  of  the  splint.  Place  the  splint 
under  the  limb.  A  cravat  bandage  should  be  passed  around  the 


FIGURE    51. — Dressing   for   fracture   of   kneecap. 

thigh  and  the  splint  and  tied  at  the  upper  end  of  the  splint. 
Place  the  center  of  a  second  cravat  bandage  over  the  thigh,  just 
above  the  kneecap ;  bring  the  ends  down  around  the  limb,  cross- 
ing them  at  the  bend  of  the  knee ;  then  bring  them  forward  and 
tie  them  below  the  kneecap.  Place  the  middle  of  a  third  cravat 
bandage  below  the  kneecap  over  the  knot  of  the  first  bandage, 
pass  the  ends  around  the  leg,  crossing  them  underneath  the 
knee,  and  bringing  them  around  the  lower  part  of  the  thigh,  and 
tie  them  above  the  kneecap.  Place  a  fourth  cravat  bandage 
around  the  limb  and  the  splint  at  the  ankle.  (See  fig.  51.) 


96      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 
FRACTURE  OF  LEG. 

By  a  fracture  of  the  leg  is  meant  a  break  of  the  bone  or  bones 
leading  from  the  knee  to  the  ankle.  This  fracture  can  usually 
be  easily  detected.  It  may  be  caused  by  direct  or  indirect 
violence.  The  symptoms  are  pain,  swelling,  and  deformity. 
There  may  be  shock.  For  the  reason  that  the  shin  bone  is 
directly  underneath  the  skin,  especial  care  must  be  taken  with 
this  fracture  as  it  is  easily  converted  into  a  compound  fracture. 

Grasp  the  foot  and  place  the  limb  in  as  nearly  normal  a  posi- 
tion as  possible.  At  the  same  time  the  bones  on  both  sides  of 
the  fracture  should  be  supported  by  placing  the  hands  under- 
neath the  limb.  Use  two  splints,  well  padded.  These  splints 


FIGURE  52. — Dressing  for  fracture  of  leg  or  ankle, 
should  be  of  sufficient  length  to  reach  from  the  middle  of  the 
thigh  to  an  inch  beyond  the  heel.  Apply  splints  to  either  side 
of  limb,  and  use  four  cravat  bandages  as  follows:  Place  the 
first  bandage  just  above  the  fracture ;  the  second  just  below  the 
fracture,  the  third  at  the  upper  part  of  the  splints,  and  the 
fourth  around  the  ankle.  All  knots  should  be  tied  over  the  outer 
splint  (See  fig.  52.) 

'    FRACTURE  OF  ANKLE. 

The  symptoms  of  this  fracture  are  pain  and  swelling,  and 
usually  there  is  deformity.  Apply  dressing  as  for  a  fracture 
of  the  leg.  (See  fig.  52.) 


FRACTURES.  97 

FRACTURE  OF  FOOT  OR  TOE. 

Such  fractures  may  be  caused  by  direct  or  indirect  violence. 
The  symptoms  are  pain  and  swelling ;  there  may  or  may  not  be 
deformity. 

Apply  a  well  padded  splint,  4  inches  wide 
and   one-fourth   inch   thick,    reaching   from 
one-half  inch  beyond   the  toes   to   one-half 
inch  beyond  the  heel.     Place  the  mid- 
dle of  a  cravat  bandage  over  the  splint 
at   the   sole   of   the   foot, 
carry  the  ends  to  the  in- 
step, across  it,  and  to  the 
back  of  the  ankle;   cross 
them     again     and     carry 
them  again  to  the  instep  ;    FIGURE  53. — Dressing  for  fracture  of  foot 
then  cross  them  under  the 
sole  of  the  foot,  carry  them  to  the  instep,  and  tie.     ( See  fig.  53. ) 

PLACING  BANDAGES  UNDER  SPLINTS. 

In  passing  cravat  bandages  beneath  splints  in  dressing  a  frac- 
tured thigh,  leg,  ankle,  or  knee,  there  is  no  objection  to  placing 
a  thin  narrow  stick  of  wood  in  the  middle  of  each  bandage, 
pushing  the  bandage  under  the  splints,  and  then  removing  the 
stick.  Catch  the  loop  thus  made  and  pull  it  with  the  fingers 
until  it  reaches  the  upper  part  of  the  splint  on  the  inner  side. 
Place  one  of  the  ends  of  the  bandage  to  the  left  side  of  the 
loop,  put  the  other  end  through  the  right  side  of  the  loop,  and 
pull  the  loop  until  the  two  ends  can  be  tied  in  a  knot  midway 
between  the  top  and  the  bottom  edges  of  the  outer  splint. 


98      ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 
COMPOUND   FRACTURES. 

In  a  compound  fracture  the  bone  is  broken  and  the  skin  and 
tissue  are  punctured  or  torn.  Such  a  fracture  is  very  dangerous. 
If  there  is  severe  bleeding,  check  it  by  means  of  a  tourniquet ; 
then  apply  a  bandage  compress  to  the  part  and  tie  the  bandage 
firmly  in  place.  If  a  bone  is  protruding,  do  not  apply  the  bandage 
compress  tightly,  as  it  will  push  the  bone  back  into  the  tissues. 
Place  two  splints  on  the  injured  limb ;  the  one  nearest  the 
wound  should  be  padded  well,  the  padding  being  arranged  so  as 
to  make  an  arch  over  the  wound.  This  precaution  will  prevent 
the  bone  from  being  pushed  back  into  the  tissues.  Keep  the 
padding  about  2  or  3  inches  from  the  wound  on  each  side. 
Always  have  a  tourniquet  in  place,  ready  to  be  tightened  if 
necessary. 

BURNS   OR  SCALDS. 

A  burn  is  an  injury  caused  by  the  application  of  heat,  either 
dry  or  moist.  Included  in  the  dry  form  are  fires,  gas  explo- 
sions, electric  current,  etc.  Moist  heat,  from  steam,  hot  water, 
etc.,  produces  what  are  known  as  scalds. 

Remove  all  loose  clothing,  but  do  not  try  to  remove  clothing 
that  adheres  to  the  skin — cut  around  it.  For  all  cases  of  burns, 
the  air  should  be  excluded  from  the  burned  surfaces  as  quickly 
as  possible  by  the  application  of  0.5  to  1  per  cent  picric  acid 
gauze,  moistened  if  possible  with  steam  or  clean  water.  In 
applying  this  gauze  you  must  be  careful  not  to  bandage  together 
open  surfaces,  such  as  fingers  or  toes  or  the  ears  to  side  of 
head.  If  the  patient  is  suffering  from  shock,  treat  it.  The 
danger  from  a  burn  depends  upon  its  depth  and  extent  and  the 
age  and  general  condition  of  the  person  injured.  For  all  burns 
of  the  body,  except  of  the  chest,  back,  head,  or  face,  for  which 


BURNS  OR  SCALDS. 


there  are  special  dressings,  first  apply  picric  acid  gauze  and 
then  cover  with  a  tri- 
angular bandage,  en- 
circling the  limbs  as  in 
the  ordinary  dressing 
for  a  wound.  Do  not 
pull  the  bandage  tight. 

BURNS    OF   BACK. 

Cover  all  burned  sur- 
faces with  picric-acid 
gauze.  Then  cover 
with  triangular  band- 
ages as  follows :  Place 
the  base  of  the  tri- 
angle of  one  bandage 
diagonally  across  the 
back,  reaching  from 
uiie  side  of  the  body 
across  the  top  of  the 
opposite  shoulder  -, 
bring  the  long  end  for- 
ward to  the  chest: 
then  bring  the  two 
lower  ends  around  the 

waist  and  tie  all  the  FlGURE  54._DreSsing  for  burns  of  back, 
ends  together  in  front.  Picric-acid  gauze  applied  underneath 
Place  a  second  triangu-  bandage. 

lar  bandage  in  a  similar  manner  on  the  opposite  side.     This  dress- 
ing may  also  be  applied  to  burns  of  the  shoulder.     (See  fig.  54.) 
51607°— 17 8 


100     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


BURNS  OF  CHEST. 

Remove  all  clothing  from  the  burned  surfaces,  apply  picric 
acid  gauze,  and  cover  as  follows:  Apply  bandages  as  described 

for  treating  burns  of  the 
back,  only  in  reverse  order. 
(See  fig.  54.) 


BURNS  OF  FACE,  HEAD, 
NECK. 


OR 


at  the 
gauze 
55.) 


Apply  picric  acid  gauze 
over  the  burned  surface,  and 
over  this  place  a  triangular 
bandage,  as  follows:  Place 
the  base  of  the  bandage  on 
the  neck  below  the  chin,  the 
apex  passing  over  the  face 
and  the  head  to  the  back  of 
the  head.  Then  pass  the 
ends  to  the  back  of  the  head, 

cross  them,  return  them 
55. — Dressing  for  burns  of  ,  ,.  ,-,  ,, 

face,  head,  and  neck.  under  the  chin,  and  tie.  Pull 

the  apex  down  and  fasten  it 

back  of  the  head.  Small  holes  should  be  cut  in  the 
and  bandage  for  the  eyes,  mouth,  and  nose.  (See  fig. 


RUPTURES.  101 

BURNS  Or  ^RMS. 

A  burn  of  the  arm  should  be  dressed  by  applying  picric  acid 
gauze,  and  then  bandaged  loosely,  an  open  triangular  bandage 
encircling  the  arm  being  used.  Place  the  apex  on  the  point  of 
the  shoulder  and  the  base  at  the  wrist,  encircle  the  limb  several 
times  with  the  ends,  and  tie  them  in  the  middle  of  tlie  arm. 

BURNS  OF  HANDS. 

Place  picric-acid  gauze  over  burned  surfaces;  prevent  the 
raw  surfaces  of  the  fingers  from  touching  each  other  by  placing 
the  gauze  between  them ;  then  dress  as  for  an  injury  to  the 
hand,  using  a  triangular  bandage. 

RUPTURE. 

Rupture  is  mentioned  in  this  book  because  it  is  usually  due 
to  severe  muscular  efforts  incident  to  violent  exercise  or  hard 
labor. 

The  lower  part  of  the  abdomen  on  each  side  is  weak  and 
occasionally  muscular  strain  will  force  a  part  of  the  intestines 
through  one  of  these  weak  places.  Thus  a  rupture  will  be 
caused.  The  only  method  of  prevention  that  can  be  suggested 
is  the  avoidance  of  such  muscular  strains,  but,  of  course,  this 
suggestion  is  hardly  practical. 

When  a  rupture  occurs  there  will  be  a  sharp,  stinging  pain,  a 
faint  feeling,  sickness  at  the  stomach,  and  a  feeling  that  some- 
thing has  given  away ;  a  lump  will  appear  in  the  groin.  As  this 


102     ADVANCED  FI&ST  AID  INSTRUCTIONS  FOR  MINERS. 

lump  conUims  intestines  or"  bowels,  or  the  covering  of  the 
bowels,  it  must  be  handled  with  the  greatest  gentleness,  as 
rough  handling  may  cause  a  dangerous  injury  to  the  Intestines 
and  probably  inflammation  of  the  bowels. 

The  patient  should  be  placed  on  his  back  with  his  knees  well 
raised  toward  the  abdomen  and  the  legs  supported  with  a  pillow 
or  folded  jacket.  Cloths  wet  in  cold  water  should  then  be 
placed  over  the  hernia,  or  lump,  and  a  doctor  should  be  sent  for 
immediately.  If  the  patient  should  be  removed  before  the 
doctor's  arrival,  carry  him  in  the  position  suggested  above. 
Never  force  him  to  lie  in  a  straight  position. 


POISONS. 

It  is  not  expected  that  a  first-aid  man  shall  become  perfectly 
familiar  with  treating  persons  affected  by  all  the  different  kinds 
of  poisons,  or  be  able  to  recognize  the  symptoms  of  each  kind, 
but  it  is  absolutely  essential  that  he  should  be  able  to  treat  for 
all  the  more  common  ones,  and  in  a  general  way,  at  least,  to 
give  first-aid  treatment  to  all  cases,  irrespective  of  what  poison 
has  been  taken.  Only  the  poisons  that  are  swallowed  are  here 
considered.  The  following  •  outline  will  enable  a  person  to 
arrive  at  some  intelligent  conclusion: 

CORROSIVE  POISONS. 

The  corrosive  poisons  when  swallowed  will  leave  a  stain  on 
the  lips  or  mouth.  They  also,  as  the  name  implies,  corrode  or 
eat  away  the  tissue  with  which  they  came  in  contact.  Belong- 
ing to  this  class  are  the  following : 

Hydrochloric  acid. 

Sulphuric  acid. 

Nitric  acid. 

Potash  or  caustic  potash. 

Soda  or  caustic  soda. 

Ordinary  lye  or  lime. 

Strong  ammonia  water. 

A  person  who  has  swallojved  one  of  these  poisons,  which  are 
the  more  common  corrosive  poisons,  will,  as  has  been  stated 
before,  have  a  stain  on  his  lips  or  on  the  inside  of  his  mouth. 

103 


104     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

He  will  also  complain  of  intense  burning  pain  in  his  throat, 
gullet,  and  stomach  if  he  is  conscious.  When  such  a  case  is 
seen  and  the  class  of  poison  is  recognized,  the  following  plan  of 
procedure  is  recommended : 

1.  Counteract  the  poison.     If  the  person  has  swallowed  an 
acid,  give  baking  soda  in  solution,  lime  off  the  walls  mixed 
with  water,  dilute  ammonia  water,  or  the  like.     If  an  alkali 
has  been  taken,  dilute  acids  are  necessary,  such  as  vinegar  or 
lemon  juice. 

2.  Soothe  the  corroded  parts.     Use  oils  especially. 

3.  Treat  for  shock.     Give  stimulants  freely  if  the  patient  is 
conscious. 

In  this  class  of  poisons  do  not  use  any  emetics,  because  the 
poison  when  vomited  will  corrode  coming  up  just  as  much  as 
going  down;  also  the  belching  will  be  liable  to  rupture  the 
stomach. 

IRRITANT  POISONS. 

The  irritant  poisons  when  swallowed  irritate  the  throat  and 
the  stomach.  They  are  also  absorbed  in  the  stomach  and 
poison  the  system  in  that  way.  The  more  common  are: 

Bichloride  of  mercury  or  antiseptic  tablets. 

All  the  combinations  of  lead. 

All  the  combinations  of  copper. 

All  the  combinations  of  zinc. 

Rat  poison,  which  is  a  compound  of  arsenic. 

Matches  or  phosphorus 

Tartar  emetic. 

Fly  poisoning. 

The  symptoms  are  pretty  much  the  same  as  for  the  corrosive 
poisons  except  that  the  lips  and  mouth  are  not  stained. 


POISONS.  105 

TREATMENT. 

1.  Give  an  emetic  (make  patient  vomit).  Run  finger  down 
throat  Have  patient  drink  large  quantities  of  warm  water. 
Have  patient  drink  salt  water.  Have  patient  drink  mustard 
water.  Have  patient  drink  alum  water. 

.2.  Soothe  the  parts  and  counteract  the  poisons.  Give  white 
of  eggs,  oils,  epsom  salts,  or  the  like.  Give  no  oils  for  poisoning 
from  matches. 

3.  Treat  for  shock.     Stimulants  should  be  given  freely. 

NERVE  POISONS. 

There  are  two  classes  of  nerve  poisons,  as  follows:  (1) 
Poisons  that  cause  deep  sleep  or  unconsciousness;  (2)  poisons 
that  cause  convulsions. 

Poisons  that  cause  deep  sleep  or  unconsciousness  include  the 
following :  Opium,  morphine,  laudanum,  paregoric,  sleeping  pow- 
ders, ether,  chloroform. 

TREATMENT  FOR   POISONS    THAT    CAUSE  UNCONSCIOUSNESS. 

1.  Try  to  keep  the  patient  awake  by  slapping  him  with  wet 
towels  and  giving  him  strong  black  coffee,  but  do  not  exhaust 
patient  by  walking. 

2.  Give  an  emetic. 

3.  Give  stimulants. 

4.  If  patient  stops  breathing,  give  artificial  respiration. 
Poisons  that  cause  convulsions  include  strychnine  and  bella- 
donna. 

TREATMENT  FOR  POISONS   THAT  CAUSE  CONVULSIONS. 

1.  Give  an  emetic. 

2.  Give  artificial  respiration  if  breathing  stops. 


106     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 
ALCOHOLIC  POISONING  AND  APOPLEXY. 

Of  the  many  cases  of  poisoning  alcoholic  poisoning  is  one  of 
the  most  common.  As  not  a  few  cases  have  occurred  among 
miners,  this  kind  of  poisoning  is  here  discussed  in  some  detail. 
The  following  symptoms  are  usually  present : 

Unconsciousness,  partial  or  complete. 

In  most  cases  the  patient  can  be  aroused  to  some  extent. 

Face  flushed  or  bloated,  but  sometimes  pale. 

Skin  cool  and  moist. 

Pupils  natural  or  large;  eyeballs  red  but  not  insensitive  to 
touch. 

No  paralysis. 

This  condition  is  often  confounded  with  apoplexy.  The 
points  of  difference  are  the  state  of  the  pupils  (in  apoplexy 
they  are  of  unequal  size),  the  sensitiveness  of  the  eyeballs,  and 
the  paralysis  that  occurs  in  apoplexy.  The  odor  of  liquor  is  of 
no  value  as  a  symptom  of  alcoholic  poisoning. 

TREATMENT    FOR    ALCOHOLIC    POISONING. 

1.  Give  an  emetic. 

2.  Afterwards  give  strong  coffee  or  aromatic  spirits  of  am- 
monia. 

3.  Make  applications  of  heat  around  patient. 

4.  Rub  body  to  increase  circulation. 

TREATMENT  FOR  APOPLEXY. 

1.  Have  patient  rest  in  a  dark  room. 

2.  Keep  his  head  and  shoulders  high  on  pillows. 

3.  Apply  cold  cloths  to  his  head. 

4.  Give  no  stimulants. 


POISONS.  107 

CARBOLIC  ACID  POISONING. 

Carbolic  acid  poisoning  is  also  common.  This  acid  is  fre- 
quently taken  with  suicidal  intent  as  well  as  accidentally.  The 
following  points  will  greatly  aid  in  discovering  the  nature  of 
the  poison. 

1.  The  bottle  that  contained  the  poison  may  be  found. 

2.  Patient  will  vomit  and  suffer  great  pain. 

3.  There  will  be  a  strong  smell  of  carbolic  acid,  which  is 
familiar  to  every  one. 

4.  Lips,  tongue,  and  mouth  of  patient  will  be  burned  white 
by  pure  acid,  and  black  by  impure  acid. 

TREATMENT. 

1.  Give  alcoholic  liquors  (whisky,  brandy,  etc.)  or  equal  parts 
of  alcohol   and   water  freely   to   dissolve  the  poison.     In   the 
absence  of  alcoholic  liquors,  give  vinegar,   soapsuds,   or  raw 
whites  of  eggs  in  water. 

2.  Produce  vomiting  by  having  the  patient  run  his   finger 
down  his  throat  or  by  drinking  any  of  the  following  liquids: 
Warm  water  in  large  quantity;   salt  water;  mustard  water; 
or  alum  water. 

3.  Give  a  solution  of  Epsom  or  Glauber  salt  or  sodium  phos- 
phate well  diluted  to  hasten  elimination  of  acid  that  may  have 
entered  the  circulation. 

Milk,  gruel,  flaxseed  tea,  or  elm-bark  tea  may  then  be  given. 
Apply  hot-water  bottles,  hot  bricks,  or  lighted  safety  lamps  to 
the  extremities,  but  make  sure  that  they  are  wrapped  so  that 
they  will  not  burn  the  patient.  For  collapse  give  strong  coffee. 
Apply  artificial  respiration  if  breathing  stops. 

Do  hot  give  oils  or  glycerin. 


TRANSPORTATION  OF  INJURED. 

After  an  injured  man  has  been  treated,  only  half  of  the  first- 
aid  man's  work  is  done.  The  next  thing  to  do  is  to  carry  the 
injured  man  to  a  hospital  or  a  doctor  by  placing  him  on  a 
stretcher  and  transporting  him  without  causing  him  any  un- 
necessary pain  or  injury.  No  matter  how  well  you  prepare  an 
injured  man  for  the  doctor,  your  work  may  all  be  undone  by  bad 
transportation. 

ONE-MAN  CARRY. 

In  lifting  an  unconscious  man,  the  bearer  turns  the  patient 
over,  face  downward,  and  then  places  himself  at  the  patient's 
head,  facing  him.  He  passes  his  hands  under  the  patient's  arm- 
pits and  lifts  him  to  his  knees.  The  bearer's  hands  should  then 
be  shifted  lower  down  and  clasped  behind  the  patient's  back. 
With  this  grip  the  patient  may  be  raised  to  a  standing  position. 
The  bearer  supports  the  patient  while  he  stoops  down  and  places 
himself  so  that  his  right  shoulder  comes  under  the  patient's  abdo- 
men, the  upper  part  of  the  patient's  body  lying  over  his  shoul- 
der. The  bearer  then  grasps  the  patient's  right  wrist  in  his  left 
hand  and  brings  it  down  and  around  under  his  left  arm  from 
behind,  while  he  passes  his  right  arm  through  between  the 
thighs;  he  then  shifts  the  patient's  right  hand  so  that  it  is 
clasped  by  the  hand  which  passes  between  the  thighs.  The 
bearer  then  rises.  By  this  method  the  patient  will  be  securely 
held  over  the  bearer's  right  shoulder.  ( See  fig.  56. ) 
108 


TRANSPORTATION  OF  INJURED. 


109 


TWO-MAN  CARRY. 

The  bearers  kneel  on  each  side  of  the  injured  person,  near  his 
hips  and  raise  him 
to  a  sitting  posi- 
tion. Each  then 
passes  one  arm 
around  the  pa- 
tient's back  and 
the  other  under 
his  thighs,  the 
bearer  on  the  pa- 
tient's right  grasp- 
ing with  his  right 
hand  the  left  wrist  f 
of  his  companion, 
the  bearer  on  the 
left  grasping  with 
his  left  hand  the 
right  wrist  of  the 
first  bearer.  Both 
rise  slowly  from 
the  ground  and 
lift  their  disen- 
gaged hands  to 
each  other's  shoul- 
ders, thus  form- 
ing a  back  rest 
for  the  patient ; 
or,  unless  the  pa-  FIGUKE  56.— One-man  carry. 


110     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 


tient  is  helpless,  he  may  support  himself  by  placing  an  arm 
around  the  neck  of  each  bearer.     (See  fig.   57.) 

HOW     ONE     PERSON     MAY 
REMOVE     AN     INJURED 
OR    UNCONSCIOUS    PER- 
SON   IN    LOW    COAL    OR 
A  THIN  VEIN. 
Place  the  injured  person 
on  his  back ;   tie  the  ends 
of     two     cravat     bandages 
together,    making    a    loop ; 
pass  this  over  the  person's 
head  and  down  so  that  it 
will  be  under  his  back  and 
around    his    sides    at    the 
armpits;  then  get  on  your 
knees,    straddling    the    in- 
jured person,  pass  the  loop 
over  your  head,  and  then, 
by  crawling,  you  can  drag 
him  out.     Occasionally  this 
purpose  is  accomplished  by 
tying    the    person's    wrists 
together.    The  rescuer  then 
passes    his    head    between 
the  arms.    Another  method 
is    to    crawl    with    an    in- 
jured person  on  your  back,  having  first  tied  his  wrists  together 
and  passed  your  head  through  the  loop  formed  by  his  arms 


FIGURE    57. — Two-man    carry. 


TRANSPORTATION  OF  INJURED.  Ill 

STRETCHERS. 

The  ordinary  stretcher,  known  as  the  Army  stretcher  (see 
fig.  64,  p.  121 ) ,  consists  of  two  long  poles  with  a  bed,  usually  made 
of  canvas,  between  them,  and  crosspieces  to  keep  the  long  poles 
apart  and  thus  to  stretch  the  canvas.  The  poles  are,  long  enough 
to  afford  handholds  for  the  bearers  at  each  end  of  the  stretcher. 

Satisfactory  stretchers  may  be  improvised — that  is,  may  be  put 
together  on  the  ground  with  the  materials  at  hand.  A  good 
stretcher  may  be  made  from  three  or  four  coats.  The  sleeves  of 
the  coats  are  turned  inside  out,  and  through  them  are  passed 
the  two  poles.  The  flaps  are  then  turned  down  around  the  poles 
and  buttoned  underneath.  • 

In  making  a  stretcher  from  a  blanket  or  canvas,  place  one 
of  the  poles  on  the  unfolded  blanket  about  1  foot  from  its  cen- 
ter. Fold  the  short  side  of  the  blanket  over  the  pole  toward  the 
other  side;  place  the  second  pole  on  the  two  thicknesses  about 
2  feet  from  the  other  pole ;  fold  the  remaining  side  of  the  blanket 
over  the  last  pole  toward  the  first  pole.  By  this  method,  when 
the  injured  person  is  placed  on  the  blanket,  the  folds  are  locked 
by  the  friction. 

Bags  and  sacks  may  be  used  for  stretcher  beds.  The  bottoms 
of  the  bags  should  be  ripped  so  that  the  poles  may  be  passed 
through  them,  and  a  sufficient  number  of  bags  should  be  used  to 
give  the  length  of  bed  required. 

TYPES  OF   STRETCHERS. 

Among  the  types  of  stretchers  used  in  first-aid  work  are  the 
following : 

An  improvised  stretcher  made  with  two  long  poles  and  brat- 
tice cloth,  blankets,  or  coat  jumpers. 


112     ADVANCED  FIKST-AID  INSTRUCTIONS  FOR  MINERS. 

Stretcher  of  the  Army  type.     ( See  fig.  64,  p.  121. ) 

A  stretcher,  known  as  the  Stokes  Navy  stretcher,  consisting  of 
woven-wire  basket  made  to  fit  the  human  body.  The  patient, 
after  having  been  strapped  to  the  basket,  may  be  placed  in  a 
vertical  position  and  carried  on  a  cage  or  skip.  This  type  of 
stretcher  is  used  almost  exclusively  in  metal  mines  or  in  coal 
mines  where  the  coal  bed  has  a  steep  pitch. 

Shields  stretcher. 

Williams  stretcher  (hammock  shape). 

Homesteak  stretcher  (used  only  in  metal  mines). 

It  is  well  always  to  test  these  stretchers  by  placing  an  unin- 
jured man  on  them.  Great  care  must  always  be  exercised  in 
placing  an  injured  man  on  a  stretcher,  otherwise  the  patient  will 
be  subjected  to  unnecessary  suffering.  The  bearers  should  work 
together  on  command  of  the  captain  or  of  the  man  in  charge. 
Whenever  possible  a  mine  car  should  be  used  in  transporting 
the  injured  out  of  a  mine,  the  stretcher  being  either  fastened  or 
held  in  the  car  to  prevent  unnecessary  shaking  of  the  patient. 
The  car  should  be  taken  out  alone  and  not  with  the  loaded  trip, 
and  such  a  car  should  always  have  the  right  of  way.  No  matter 
how  well  trained  may  be  the  men  who  have  charge  of  the  injured, 
it  is  impossible  to  carry  an  injured  man  along  the  roadbed  in  a 
mine  without  irregular  stepping  and  jolting.  Some  of  the  coal 
companies  have  met  this  problem  of  transportation  of  the  in- 
jured out  of  mines  in  an  efficient  way  by  providing  special  ambu- 
lance tramcars.  It  is  hoped  that  this  method  may  soon  become 
universal.  In  handling  an  injured  man,  with  or  without  stretcher, 
the  bearers  should  move  together  and  as  gently  as  possible. 


TRANSPORTATION   OF  INJURED. 
STRETCHER  DRILL." 


113 


The  stretcher  squad  shall  consist  of  four  men  under  the  com- 
mand of  a  captain,  whose  words  of  command  shall  be  obeyed,  as 
outlined  below. 


FIGURE  58. — "  Fall  in  line — Count  one,  two,  three,  four." 

The  stretcher  drill  described  below  is  recommended  for  use 
in  first-aid  contests. 

a  See  figs.  58,  59,  60,  61,  62,  and  63. 


114     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

The  captain  shall  give  all  commands  in  a  military  manner  ;  that 
is,  first  to  give  a  preparatory  command,  so  as  to  place  each  man 
in  readiness,  and  follow  this  command  after  a  definite  interval 
of  one  or  two  seconds  by  the  final  command.  Following  this 


FIGURE  59. — Crew  in  line,  No.  3  having  obtained  stretcher. 

method,  the  movements  can  easily  be  made  in  unison,  and  con- 
sequently more  satisfactorily  and  efficiently.  The  dash  ( — )  in 
the  command  as  given  represents  the  interval  between  the  pre- 
paratory and  the  final  command. 


TRANSPORTATION  OF  INJURED. 


115 


CAPTAIN  :  "  Fall  in."  The  four  men  fall  in  line,  standing  side 
by  side,  each  with  head  erect,  hands  at  sides,  heels  together,  and 
eyes  straight  ahead.  When  each  mart  stands  at  attention  in  this 
manner  the  squad  makes  a  fine  appearance,  but  if  one  man  has 
his  feet  apart  and  another  his  heels  together  and  one  has  his 


FIGURE  60. — "Carry  stretcher — inarch. 


hand  behind  his  back  and  another  keeps  his  hands  at  his  sides 
the  squad  does  not  make  a  good  impression  on  either  judges  or 
spectators. 

CAPTAIN:  "Count  off."    The  man  at  the  right  of  the  squad 
(looking  toward  patient)  calls,  "  One,"  and  the  remainder  of  the 
squad  follow  in  order,  counting,  "  Two,"  "  Three,"  "  Four." 
51607°— 17 9 


116     ADVANCED  FIRST-AID  INSTRUCTIONS  FOB,  MINERS. 

CAPTAIN  :  "  Procure  stretcher — march."  At  the  command 
"  March,"  No.  3  steps  forward  and  proceeds  to  the  stretcher  by 
the  shortest  route,  picks  it  up  and  places  it  over  his  right  shoul- 
der as  shown  in  figure  59  and  returns  to  his  place  in  line. 

CAPTAIN  :  "  Carry  stretcher — march."  At  the  command 
"  March,"  No.  3  tilts  the  stretcher  on  his  shoulder  and  holding 


FIGURE  61. — Placing  patient  on  stretcher. 

one  end  allows  the  other  end  of  the  stretcher  to  fall  slowly 
forward.  At  the  same  time  No.  2  takes  two  long  paces  to  the 
front  and  as  tjie  stretcher  drops  forward  he  catches  the 
handles  at  the  free  end  with  his  left  hand.  No.  1  steps  to  the 
middle  of  the  right-hand  side  of  the  stretcher  while  No.  4  steps 
to  the  middle  of  the  left-hand  side. 


TRANSPORTATION  OF  INJURED. 


117 


CAPTAIN  :  "  To  patient,  forward — march."  After  reaching  the 
patient,  Nos.  2  and  3  open  the  stretcher  and  fix  the  braces, 
Nos.  1  and  4  take  their  places  beside  the  patient,  No.  1  on  the 
patient's  right,  and  No.  4  on  the  patient's  left  side. 

CAPTAIN:  "Post  to  patient's  right  side"  (or  left  side,  as  the 
case  may  be). 


FIGURE  62. — Lifting  patient. 


CAPTAIN  :  "  Prepare  to  lift  patient."  Each  of  the  four  men 
kneel,  No.  2  opposite  the  patient's  knees,  No.  3  opposite  the 
patient's  shoulders,  and  Nos.  1  and  4  opposite  the  patient's  hips 
on  their  respective  sides.  Nos.  2  and  3  kneel  on  the  uninjured 
side  of  the  patient,  thus  having  three  men  on  this  side,  unless 
the  nature  of  the  patient's  injuries  makes  it  desirable  to  have 


118     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

three  men  on  the  injured  side.  Each  of  the  three  men  kneels 
on  the  knees  nearest  the  patient's  feet.  No.  3  places  his  hands 
under  the  patient's  neck  and  shoulders,  No.  2  places  his  hands 
under  the  patient's  knees  and  thighs,  while  Nos.  1  and  4  place 
their  hands  under  the  patient's  pelvis  and  the  small  of  his  back, 

CAPTAIN  :  "  Lift — patient."  The  patient  is  slowly  raised  and 
supported  on  the  knees  of  the  three  men,  the  other  man  places 
the  stretcher  under  the  patient. 

CAPTAIN  :  "  Prepare  to  lower  patient."  The  man  who  has 
placed  the  stretcher  kneels  and  places  his  hands  in  position  to 
support  the  patient. 

CAPTAIN  :  "  Lower — patient."  The  patient  is  gently  lowered  to 
stretcher. 

CAPTAIN  :  "  Posts  to  carry  stretcher — march."  No.  3  takes  his 
place  at  the  rear  end  of  the  stretcher.  The  patient 'is  carried 
on  the  stretcher  feet  first,  the  end  nearest  his  feet  being  the 
front  and  the  end  nearest  his  head  the  rear;  No.  2  takes  his 
position  at  the  front  end,  and  Nos.  1  and  4  stand  on  either  side. 
Nos.  2  and  3  face  each  other  and  Nos.  4  and  1  face  each  other. 

CAPTAIN  :  "  Prepare  to  lift."  All  stoop  and  grasp  the  stretcher, 
Nos.  2  and  3  by  the  handles  and  Nos.  1  and  4  at  the  sides. 

CAPTAIN  :  "  Lift — stretcher."  The  stretcher  is  gently  and 
slowly  raised.  No.  1  and  No.  4  each  shifts  one  hand  toward  the 
front  of  the  stretcher  and  supports  this  end  while  No.  2  turns  to 
the  marching  position.  If  the  patient  is  suffering  from  severe 
bleeding  of  the  head,  and  must  be  carried  up  a  steep  grade  on  a 
stretcher,  his  head  should  be  carried  first  with  No.  3  bearer 
leading. 

CAPTAIN  :  "  Forward — march."  Nos.  1,  2,  and  4  each  steps  off 
with  his  left  foot  while  No.  3  steps  off  with  his  right  foot.  This 
procedure  prevents  the  stretcher  from  swaying. 


TRANSPORTATION  OP  INJURED. 


119 


In  marching,  when  necessary  to  turn: 

CAPTAIN  :  "  Squad  right — march,"  or,  "  Squad  left — march," 
as  the  case  may  be. 

On  reaching  the  ambulance  the  command  is  given : 

CAPTAIN  :  "  Squad — halt."  At  the  command  "  Halt  "  each 
man 'takes  an  additional  step  forward  and  then  brings  the  foot 


FIGURE  63. — Prepared  to  carry  patient. 

in  the  rear  up  to  a  heel-to-heel  position  with  the  foot  that  is 
forward.  ' 

CAPTAIN  :  "  Lower — stretcher." 

CAPTAIN:  "Take  posts  to  load  ambulance."  The  captain 
opens  the  ambulance  door  and  takes  his  place  in  the  ambulance. 

Patient  is  loaded  head  first. 


120     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

No.  3  steps  to  the  right  side  of  the  stretcher,  opposite  the 
patient's  head ;  No.  2  to  the  left  side  of  the  stretcher,  opposite 
the  patient's  feet ;  No.  1  moves  toward  the  patient's  feet  on  his 
side  and  No.  4  toward  the  patient's  head  on  his  side,  so  that 
Nos.  1  and  2  face  each  other,  and  Nos.  3  and  4  also  face  each 
other. 

CAPTAIN  :  "  Prepare  to  lift  stretcher."  All  four  stoop  and 
grasp  the  stretcher  with  arms  outstretched,  so  as  to  support 
the  ends  and  the  middle  of  the  stretcher. 

CAPTAIN  :  "  Load — ambulance."  All  rise  to  an  erect  position 
and  side  step  to  the  ambulance.  The  front  men  place  their  end 
of  the  stretcher  on  the  ambulance  floor  and  step  to  the  side, 
while  the  rear  men  push  the  stretcher  forward  into  position 
in  the  ambulance.  The  captain  carefully  holds  the  stretcher 
from  swaying. 

If  in  marching  with  a  loaded  stretcher  it  becomes  necessary 
to  cross  an  obstacle : 

CAPTAIN  :  "  Squad — halt." 

CAPTAIN  :  "  Prepare  to  cross  obstacle."  Nos.  1  and  4  grasp 
the  handles  with  their  free  hands,  relieving  No.  2,  so  that  he 
can  cross  the  obstacle.  Nos.  1,  4,  and  3  then  advance  the 
stretcher  over  the  obstacle  to  a  point  where  No.  2  who  is  on  the 
other  side  can  grasp  and  support  the  handles  at  the  front  end. 
Nos.  1  and  4  then  cross  the  obstacle  and  again  obtain  side  holds 
on  the  stretcher,  relieving  No.  3  and  carrying  the  stretcher 
forward  with  the  assistance  of  No.  2.  No.  3  then  crosses  the 
obstacle  and  takes  his  normal  position. 

Owing  to  restricted  passages  and  numerous  obstructions,  it  is 
sometimes  impossible  to  carry  a  patient  on  a  stretcher  within 


TRANSPORTATION  OF  INJURED. 


121 


a  mine  according  to  the  directions  outlined  above  hence  the 
following  method  has  been  adopted: 


8     9 


FIGURE  64. — Stretcher  of  army  type  and  first-aid  splints.  1,  padded 
broken-back  splint,  back  view ;  2,  stretcher ;  3,  blanket ;  4,  forearm 
splint ;  5,  padded  elbow  splint ;  6,  7,  splints  for  upper  leg ;  8,  9, 
splints  for  lower  leg. 

To  transport  the  injured  on  a  stretcher  of  the  Army  type  (fig. 
64)  in  a  mine  the  rescuers  should  be  in  a  position  to  see  where 


122     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

they  step.  For  carrying  a  patient  underground  the  four  rescuers 
should  each  take  hold  of  a  handle  of  the  stretcher  and  use  the 
free  hand  for  carrying  a  light.  The  captain  should  precede 
and  select  the  route,  Nos.  2  and  4  taking  lead  handles  and 
Nos.  3  and  1  the  rear  handles  of  the  stretcher. 

A  figure  showing  stretcher  drill  was  prepared  by  Mr.  James 
C.  Bennett,  safety  engineer  of  the  California  Industrial  Accident 
Commission.  Figure  65  is  adapted  from  that  figure  to  conform 
with  standardization  requirements.  It  simplifies  the  work  of 
stretcher  drill.  In  each  mine  rescue  car,  station,  and  truck 
similar  diagrams,  enlarged,  will  be  on  exhibition  for  the  benefit 
of  those  taking  first  aid. 


TRANSPORTATION  OF  INJURED. 


"FALL  IN" 

"PREPARE  TO  LIFT  PATIENT" 
©Captain             . 

r>      i  —  1 

"LOAD  AMBULANCE" 

Captain 

©ADO 

1234 

:°H 

*A/\ 

rJ||L 

©Captain                             Q 

II       i] 

0 

"PROCURE  STRETCHER-  MARCH" 

"LOWE/?  PATIENT" 

©Captain      .      , 

'PREPARE  TO  CROSS  OBSTACLE" 

|  O     A     6     0 

§    /      '     T     ¥ 

'S|]ol 

©Captain       9  1 

©     Stretcher      \ 

J/7?#/7  0/7  uninjured  side        (F) 

Bearers  fec/ng~~^r~=:i-'           sr\ 
strefcher.       J    A.?                  (^j 

\B/ 

"CXAW  STRETCHER-MARCH" 
©Captain      y  ^^ 

T 

© 

'^WTy  TO  CARRY  STRETCHER" 

©Captain       Q5 

1  *  . 

Ai 
Facing  Forward                           (J) 

OPENING  STRETCHER 

Tfi 

'O|0« 
/"«//<•/>/  j  —  1 

*TAKEPOSTSTOLOAO  AMBULANCE^ 

©Captain      "o|| 

A"         O 

FIGURE  65. — Diagram  of  stretcher  drill. 


SUNSTROKE. 

Sunstroke  is  caused  by. prolonged  exposure  to  the  direct  rays 
of  the  sun  or  to  excessive  heat  indoors.  The  symptoms  come  on 
rather  suddenly  and  are  as  follows  : 

The  patient  is  always  unconscious. 

His  face  is  red  and  flushed. 

His  skin  is  hot  and  dry. 

No  perspiration  whatsoever  is  present. 

The  patient's  breathing  is  labored  and  of  a  snoring  character. 

The  pupils  of  his  eyes  are  enlarged. 

His  pulse  is  slow  and  full. 

The  treatment  required  is  to  reduce  the  temperature  of  the 
body  as  quickly  as  possible.  To  do  this,  remove  the  patient  at 
once  to  a  cool  place  and  take  off  as  much  of  the  clothing  as  is 
necessary;  apply  ice  or  cold  water  to  his  head  and  body.  To 
accomplish  this  effectively,  place  the  patient  in  a  cold  bath  and 
rub  continuously  to  prevent  shock.  Keep  up  the  cold  applications 
until  consciousness  returns.  Then  give  the  patient  all  the  cool 
water  he  wants.  If  the  skin  becomes  hot  and  dry  again,  renew 
the  cold  treatment.  Give  no  stimulants. 

HEAT  EXHAUSTION. 

Heat  exhaustion  is  collapse  from  the  effects  of  heat.  It  is 
generally  not  a  serious  condition  if  proper  treatment  is  given. 
The  symptoms,  which  are  directly  opposite  to  those  of  sunstroke, 
are  as  follows : 

The  patient  is  never  unconscious. 
124 


SNAKE  BITES.  125 

His  face  is  generally  pale  and  anxious  looking. 
His  skin  is  covered  with  a  clammy  perspiration. 
His  breathing  is  shallow,  there  being  little  expansion  of  the 
chest. 

His  pulse  is  weak  and  fast. 

The  treatment  is  the  same  as  for  shock. 

FROST  BITES  AND  FREEZING. 

About  the  only  effect  produced  by  exposure  to  cold  that  need 
be  discussed  here  is  frost  bite  or  freezing  of  certain  parts  of  the 
body.  The  parts  most  liable  to  be  affected  are  the  ones  most 
exposed,  such  as  the  nose,  ears,  fingers,  and  toes.  The  affected 
part  is  white  and  all  sensation  is  lost. 

In  the  treatment,  rub  the  affected  part  with  snow  or  cold 
water ;  then  use  warmer  water  gradually.  Give  hot  coffee,  hot 
tea,  or  aromatic  spirits  of  ammonia.  The  object  is  to  bring 
the  frozen  part  to  its  normal  temperature.  To  immediately 
expose  the  part  to  heat  might  result  in  gangrene  or  death  of 
the  part. 

SNAKE  BITES. 

Snake  bites  are  usually  very  dangerous.  The  patient  will  feel 
a  stinging  pain,  and  there  will  be  a  small  pin-point  wound,  which 
will  be  followed  by  swelling.  Apply  an  improvised  tourniquet 
just  above  the  wound,  between  the  wound  and  the  heart  to 
stop  circulation  of  the  blood.  Loosen  the  tourniquet  every  20 
minutes  for  one-half  minute  to  prevent  gangrene.  With  the 
tip  of  a  knife  blade  open  the  holes  made  by  the  snake's  fangs, 
cutting  lengthwise  of  the  limb.  Let  blood  run  from  the  cut, 
at  the  same  time  rubbing  the  wound  with  the  fingers  to  dis- 
lodge any  of  the  poison  that  remains.  Suck  the  wound.  There 


126     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

is  no  danger  in  doing  so  provided  you  do  not  swallow  the  blood 
and  you  have  no  wound  in  or  about  the  mouth.  Wash  wound 
with  whiskey  rather  than  give  it  to  the  sufferer.  Rub  into  the 
wound  some  baking  soda  or  permanganate  of  potash  moistened 
with  water.  If  a  hypodermic  needle  is  available,  use  it  to 
inject  a  saturated  solution  of  permanganate  of  potash  into  the 
flesh  around  the  wound. 

COUNTEBJRIIITANTS. 

Counterirritants  act  by  causing  a  dilation  of  the  vessels  of 
the  skin  and  reflexly  by  contracting  the  deeper  vessels.  The 
mustard  poultice  or  mustard  plaster  and  the  turpentine  stupe 
are  the  most  commonly  used.  They  are  employed  to  relieve 
deep-seated  pain  and  inflammation. 

MUSTARD  POULTICE. 

Take  1  part  of  powdered  mustard  to  3  or  4  parts  of  flour 
and  stir  well  into  10  parts  of  cold  water.  The  resulting  mix- 
ture may  be  spread  between  two  pieces  of  muslin,  warmed  by 
holding  near  a  fire,  and  applied  to  the  skin. 

MUSTARD  PLASTEEf. 

A  mustard  plaster  may  also  be  made  by  taking  one  part  of 
mustard  and  four  parts  of  ordinary  flour,  and  adding  sufficient 
water  to  form  a  paste.  This  is  spread  between  two  pieces  of 
muslin,  a  piece  of  stiff  paper  being  placed  behind  the  plaster  to 
give  it  added  firmness.  The  action  of  the  plaster  should  be 
watched  and  it  should  be  removed  after  the  skin  has  become 
reddened. 


COUNTERIRRITANTS.  127 

TURPENTINE  STUPE. 

A  turpentine  stupe,  or  healing  application,  may  be  made  by 
stirring  one  tablespoonful  of  turpentine  into  a  pint  of  boiling 
water.  A  piece  of  flannel  is  then  dipped  into  the  hot  solution 
and  wrung  out  by  being  twisted  in  a  towel,  and  is  then  applied 
to  the  part  while  hot.  The  stupe  is  left  in  place  until  it  pro- 
duces a  redness  of  the  skin,  but  not  long  enough  to  cause  blister- 
ing. Never  attempt  to  warm  the  turpentine  over  a  fire.  More- 
over, the  boiling  water  should  be  removed  from  the  fire  before 
the  turpentine  is  added. 


MATERIAL  FOB  ADVANCED  FIRST-AID  STUDENTS. 
DIGESTIVE  SYSTEM. 

The  digestive  system  or  alimentary  apparatus  may  be  con- 
sidered as  consisting  primarily  of  a  long  tube  composed  of  the 
mouth,  pharynx  (throat),  esophagus  (tube  leading  to  stomach), 
stomach,  and  intestines  or  bowels,  with  the  salivary  glands, 
liver,  and  pancreas  as  accessory  organs.  This  tube  or  alimentary 
canal  is  about  30  feet  long,  of  varying  diameter,  and  extends 
from  the  mouth  to  the  anus.  Its  purpose  or  function  is,  first, 
to  separate  the  nutritious  material  from  the  food  and  to  expel 
the  residue  from  the  body,  and,  second,  to  convert  the  nutritious 
matter  into  such  a  form  that  it  can  be  easily  absorbed  into  the 
blood  and  be  utilized  by  the  tissues.  To  understand  how  this  is 
accomplished,  some  knowledge  of  the  separate  parts  forming 
this  complicated  apparatus  is  necessary. 

MOUTH. 

Strictly  speaking,  the  mouth  is  only  a  cavity  when  the  lips 
and  jaws  are  open ;  at  other  times  the  whole  cavity  is  filled  by 
the  tongue.  For  the  sake  of  convenience,  however,  the  mouth 
will  be  called  an  oval  cavity  forming  the  commencement  of  the 
alimentary  canal ;  bounded  in  front  by  the  lips,  laterally  by  the 
cheeks,  behind  by  the  soft  palate  and  the  opening  of  the 
pharynx,  above  by  the  hard  palate,  and  below  by  the  floor  of 
the  mouth  and  the  tongue.  Suspended  from  the  posterior  bor- 
der of  the  hard  palate  and  narrowing  the  opening  between  the 
128 


MATERIAL  FOR  ADVANCED  FIRST-AID  STUDENTS.    129 

mouth  and  the  pharynx  is  a  movable  fold  of  mucous  membrane, 
the  soft  palate;  hanging  down  from  the  center  is  a  small  pro- 
jection, the  uvula;  extending  from  the  uvula  downward  and 
forward  on  either  side  are  two  folds  of  tissue  or  muscles  known 
as  the  pillars  of  the  soft  palate.  Between  these  two  pillars  are 
the  tonsils.  Separated  from  the  cavity  of  the  mouth  by  the  soft 
palate  is  the  pharynx  or  throat. 


The  tongue  lies  in  the  floor  of  the  mouth,  and  is  composed 
of  muscular  fibers  in  which  are  embedded  nerves  and  blood  ves- 
sels. Its  base  is  attached  to  adjacent  structures  by  numerous 
muscles,  its  tip  and  sides  being  free.  Extending  from  the  under 
surface  of  the  tongue  to  the  floor  of  the  mouth  is  a  fold  of 
mucous  membrane  called  the  frenum.  The  upper  surface  of  the 
tongue  is  covered  with  a  mucous  membrane  which  is  raised  into 
numerous  projections  and  gives  to  the  tongue  its  rough  appear- 
ance; beneath  the  mucous  membrane  lie  the  so-called  taste 
buds. 

TEETH. 

Extending  around  inside  the  lips  and  cheeks  in  the  form  of  an 
arch  are  the  two  rows  of  teeth,  32  in  all,  consisting  of  2  in- 
cisors, 1  canine,  2  bicuspids,  and  3  molars,  in  each  half  of  each 
jaw.  The  teeth  have  as  a  special  function  the  grinding  of  food, 
and  are  necessarily  made  up  of  a  very  strong,  dense  substance 
called  dentin,  which  is  covered  with  enamel,  the  hardest  sub- 
stance in  the  body.  The  interior  of  the  tooth  is  known  as  the 
pulp  cavity  and  contains  blood  vessels  and  nerves.  Each  tooth 
consists  of  three  parts — the  fang,  or  root,  which  lies  embedded 
in  the  jaw,  the  crown,  or  that  part  projecting  beyond  the 


130     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

gums,  and  the  neck,  or  that  part  covered  by  the  gums,  lying 
between  the  root  and  the  crown.  Particles  of  food,  if  allowed 
to  collect  between  the  teeth,  undergo  fermentation  and  produce 
an  acid  that  eats  away  the  enamel,  so  that  unless  the  teeth  are 
kept  properly  cleaned  decay  is  apt  to  follow. 

The  interior  of  the  mouth  is  lined  with  mucous  membrane, 
which  contains  numerous  glands,  the  buccal  glands,  and  has 
openings  upon  its  surface  for  the  ducts  of  the  salivary  glands. 
These  consist  of  three  pairs  of  glands — parotid  (near  the  ear), 
submaxillary  (under  the  jaw),  and  sublingual  (under  the 
tongue).  The  secretion  from  these  glands,  mixed  with  that  from 
the  many  small  glands  in  the  mucous  membrane  of  the  mouth, 
forms  the  saliva  or  "  spit."  It  is  an  alkaline  fluid  containing 
as  its  active  principle  a  substance  called  ptyalin  (ferment  from 
saliva),  which  has  the  property  of  changing  insoluble  starches 
into  a  soluble  sugar,  maltose. 

ESOPHAGUS- 

The  tube  or  gullet  known  as  the  esophagus  extends  down- 
ward from  the  lower  part  of  the  throat  in  front  of  the  spinal 
column  to  the  stomach.  It  is  a  canal  about  10  inches  long  and 
serves  to  convey  food  from  the  mouth  to  the  stomach. 


The  stomach  is  an  inverted,  pear-shaped,  baglike  dilated  part 
of  the  alimentary  canal  lying  between  the  esophagus  and  the 
bowels.  The  greater  part  of  it  lies  on  the  left  side  of  the  ab- 
domen below  the  large  muscles  of  respiration  and  beneath  the 
anterior  wall  of  the  abdomen.  The  larger  dilated  end,  lying  to 
the  left,  is  called  the  cardiac  extremity ;  the  smaller  end,  lying 


MATERIAL  FOE  ADVANCED  FIRST-AID  STUDENTS.    131 

to  the  right,  is  called  the  pyloric  extremity  or  gateway  to  the 
bowels ;  and  the  part  between  the  two  is  known  as  the  body.  As 
the  stomach  is  easily  distended,  its  capacity  is  subject  to  wide 
variations.  Its  average  capacity,  however,  may  be  said  to  be 
about  2^  pints.  When  it  is  moderately  distended  its  greatest 
diameter  is  10  to  12  inches.  When  empty  it  collapses. 

SMALL  INTESTINE. 

The  small  intestine  or  bowel  is  that  part  of  the  alimentary 
canal  extending  from  the  stomach  above  to  the  larger  intestine. 
It  is  about  22  feet  long  and  in  diameter  varies  from  1  to  2 
inches.  The  small  intestine  is  divided  into  three  parts:  The 
duodenum,  the  first  part,  is  10  or  12  inches  long  and  about  2 
inches  in  diameter;  the  jujenum,  the  upper  two-fifths  of  the 
small  intestine,  is  8  or  9  feet  long  and  about  1$  inches  in 
diameter ;  the  ileum,  or  the  lower  half  of  the  intestines,  is  12  to 
13  feet  long  and  about  1|  inches  in  diameter. 

LAEGE  INTESTINE. 

The  large  intestine  is  that  part  of  the  alimentary  canal  lying 
between  the  small  intestine  and  the  anus.  It  is  5  to  6  feet  long 
and  1\  inches  in  diameter  at  its  widest  point.  It  begins  on  the 
right  side  as  a  dilated  pouch  2*  to  3  inches  long,  termed  the 
cecum,  or  blind  pouch,  from  the  lower  back  part  of  which  ex- 
tends a  rudimentary  bowel,  usually  curled,  known  as  the  ver- 
miform appendix.  The  opening  of  the  bowel  is  guarded  by  a 
double  valvelike  fold  of  tissue.  From  the  blind  pouch  the  large 
intestine  or  bowel  passes  up  the  right  side  of  the  abdomen,  or 
belly,  as  the  ascending  colon.  Upon  reaching  the  liver  it  makes 
a  sharp  turn  and  passes  across  the  abdomen  as  the  transverse 

51607° — 17 10 


132     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

colon.  On  the  left  side  of  the  body  it  passes  down  as  the  de- 
scending colon  and  terminates  or  ends  in  the  rectum,  which 
opens  externally  as  the  anus. 


The  liver  is  a  dark  reddish-brown  gland  occupying  the  right 
side  and  part  of  the  left  side  of  the  abdomen,  lying  below  the 
larger  breathing  muscle  and  above  the  stomach  and  the  intes- 
tines. It  is  the  largest  organ  in  the  body,  weighing  50  to  60 
ounces  and  measuring  8i  to  9$  inches  in  its  transverse  diameter, 
4f  to  7^  inches  anteroposteriorly,  and  6i  inches  in  its  greatest 
diameter  vertically. 

GALL    BLADDER. 

The  gall  bladder  is  a  pear-shaped  receptacle  for  the  bile,  and 
is  3  to  4  inches  long  with  a  capacity  of  8  to  12  teaspoonfuls.  It 
has  a  duct  leading  from  its  smaller  end,  which  is  joined  by  a 
duct  from  the  liver,  and  the  two  form  a  larger  duct  which  emp- 
ties into  the  duodenum  or  small  bowel. 

PANCREAS. 

The  pancreas  is  a  narrow,  elongated  gland  6  inches  long,  2 
inches  broad,  and  1  inch  thick,  and  weighing  2  or  3  ounces.  It 
extends  transversely  across  the  abdomen,  the  greater  part  of  it 
lying  on  the  left  side  behind  the  stomach  and  bowels.  From  its 
interior  leads  a  duct  which  opens  into  the  small  bowel  with  the 
bile  duct. 

PROCESS   OF   DIGESTION. 

The  material  taken  into  the  body  as  food,  although  containing 
the  necessary  elements  of  nutrition,  is  often  in  an  insoluble 


MATERIAL  FOR  ADVANCED  FIRST-AID  STUDENTS.    133 

form  and  of  a  composition  far  different  from  the  tissues  it  is 
to  build  up  or  repair.  Thus  all  foods  have  to  be  digested  or 
changed  into  such  form  that  they  can  be  easily  absorbed  and 
at  the  same  time  furnish  the  necessary  nourishment  for  the 
tissues.  When  the  food  is  taken  into  the  mouth  it  is  thoroughly 
ground  and  chopped  by  the  teeth.  At  this  time  the  sali- 
vary glands  begin  to  secrete  a  large  quantity  of  saliva  which 
moistens  the  mouth  and  the  food  and  thoroughly  mixes  with 
the  latter.  The  food  thus  becomes  converted  into  a  semisolid 
mass,  and  all  parts  of  it  are  exposed  to  the  action  of  the 
saliva,  while  the  insoluble  starchy  constituents  commence  to  be 
converted  into  a  more  soluble  sugar,  maltose.  The  bolus,  as 
the  food  now  thoroughly  masticated  and  mixed  with  saliva  is 
called,  passes  back  into  the  pharynx,  but  is  prevented  from 
getting  into  the  nose  by  the  soft  palate ;  it  is  pushed  farther  back 
by  the  tongue  and,  passing  over  the  larynx  which  is  closed  by  the 
epiglottis  (a  thin  plate  over  the  tube  leading  to  the  lungs)  is 
then  grasped  by  the  muscular  walls  of  the  pharynx  (a  sac  be-' 
hind  the  mouth)  and  pushed  on  into  the  esophagus  or  tube 
leading  to  the  stomach.  This  tube  then  begins  to  contract,  from 
above  downward,  and  propels  the  bolus  along  into  the  stomach. 
As  soon  as  the  stomach  receives  the  food  an  abundant  secre- 
tion of  gastric  juice  is  poured  out  by  the  gastric  glands  and  the 
stomach  commences  to  contract.  The  food  is  thus  churned 
and  thoroughly  mixed  with  the  acid  gastric  juice  until  it  resem- 
bles a  thick  pea  soup,  and  is  now  known  as  chyme.  The  gastric 
juice  through  its  acidity  soon  prevents  any  further  digestion 
of  the  starches,  which  commenced  in  the  mouth,  but  it  acts  on 
the  proteids  (the  albuminoid  constituents  of  an  organism), 
changing  them  into  more  soluble  substances,  the  peptones  (albu- 


134     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

minoids  produced  by  the  action  of  pepsin).  Most  of  the  chyme 
passes  out  into  the  duodenum  or  small  bowel,  then  through  the 
pylorus  or  gate,  but  a  small  part  of  it — some  of  the  soluble 
sugars,  water,  and  peptones — is  probably  absorbed  directly  by 
the  blood  vessels  of  the  stomach  wall. 

As  the  chyme  passes  into  the  small  bowel  the  bile  and  the 
pancreatic  juice  are  poured  out  and  mix  with  the  acid  chyme, 
converting  it  into  an  alkaline  substance  (one  that  combines  with 
an  acid  to  form  a  neutral  salt),  the  chyle.  The  secretions  from 
the  liver  and  the  pancreas,  with  those  from  the  intestinal  glands 
themselves,  act  on  any  proteids  that  remain  undigested,  con- 
verting them  into  more  soluble  substances.  At  the  same  time 
the  conversion  of  starch  into  sugar,  which  is  interrupted  while 
the  food  is  in  the  stomach,  is  continued.  Finally  fats  and  oils 
are  emulsified  or  broken  into  minute  drops,  in  which  form  they 
are  more  readily  absorbed.  As  the  chyle  is  forced  along  the 
intestines  by  their  contraction,  the  products  of  digestion  are 
absorbed  by  the  villi  (minute  vascular  projections  from  the 
mucous  membrane  of  the  bowels).  Water,  salts,  proteids,  and 
sugar  are  taken  up  from  the  villi  by  the  blood  vessels,  and  fats 
by  the  lacteals;  the  latter  empty  into  the  thoracic  duct.  This 
duct  begins  as  a  small  sack  situated  upon  the  second  lumbar 
vertebra.  From  the  sack  it  extends  as  a  small  tube  about  the 
size  of  a  goose  quill  up  through  the  thoracic  cavity  and  enters 
into  the  vein  that  collects  the  blood  from  the  upper  extremity 
on  the  left  side. 

When  the  digested  matter  with  the  undigested  residue  reaches 
the  large  intestine  it  is  a  fluid,  but  during  its  passage  through 
the  large  intestine  the  fluids,  as  well  as  any  dissolved  substances 
which  may  have  escaped  absorption  in  the  small  intestine  are 


MATERIAL  FOR  ADVANCED  FIRST-AID  STUDENTS.    135 

absorbed.  The  contents  of  this  part  of  the  bowels  are  thus  grad- 
ually converted  into  a  solid  mass,  and  by  the  time  the  material 
reaches  the  rectum  it  is  dark  in  color,  has  a  characteristic  odor, 
and  is  known  as  feces. 

To  sum  up  the  process  of  digestion,  the  carbohydrates  only  are 
digested  while  the  food  is  passing  to  the  stomach  ;  in  the  stomach 
theptyalin  (ferment  of  saliva)  swallowed  with  the  food  continues 
to  digest  the  starches  for  a  time,  and  the  proteids  are  also 
digested  here,  and  a  small  quantity  of  water,  soluble  proteids, 
and  carbohydrates  are  probably  absorbed ;  in  the  small  intestine 
carbohydrates,  proteids,  and  fats  are  all  digested  and  absorbed ; 
and  in  the  larger  intestine  a  further  absorption  of  those  sub- 
stances and  of  the  fluid  occurs. 

EXCRETORY  SYSTEM. 

The  lungs  remove  from  the  body  a  large  quantity  of  carbonic 
acid  and  a  small  quantity  of  water,  part  of  the  fluid  exhaled  prob- 
ably coming  from  the  moisture  of  the  nostrils. 


The  secretion  in  the  skin,  the  sweat  or  perspiration,  is  a  color- 
less fluid,  with  a  salty  taste  and  a  peculiar  odor,  in  which  are 
excreted  water,  certain  salts,  carbonic  acid,  and  urea.  The 
amount  of  carbonic  acid  given  off  by  the  skin  is  less  than  0.01 
part  of  the  amount  given  off  by  the  lungs,  and  only  small  quanti- 
ties of  urea  are  normally  eliminated  by  this  route. 

There  is  always  a  little  perspiration  being  excreted,  though  we 
may  not  be  conscious  of  it ;  the  average  amount  in  24  hours  is 
about  2  pounds ;  there  may,  however,  be  only  a  few  ounces.  The 


136     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

perspiration  may  be  so  scant  that  it  immediately  evaporates, 
leaving  no  visible  residue  upon  the  skin,  if,  on  account  of  an 
increase  in  the  quantity  of  fluid  perspired,  or  on  account  of  the 
temperature,  the  perspiration  does  not  evaporate,  it  remains  in 
drops  on  the  skin.  Any  condition  causing  blood  to  circulate 
freely  through  the  skin  will  cause  an  individual  to  perspire  more 
freely.  After  eating,  after  violent  exercise,  or  in  hot  weather 
a  large  amount  of  perspiration  is  excreted. 

On  the  other  hand,  early  in  the  morning  and  in  very  cold 
weather,  when  the  skin  is  less  active,  little  perspiration  is  lost. 
The  amount  excreted  also  depends  on  the  quantity  of  fluids  a 
person  takes. 

The  function  of  the  sweat  glands  is  to  regulate  the  tempera- 
ture of  the  body.  Under  the  influence  of  high  temperature  of  the 
atmosphere  the  sweat  glands  are  stimulated.  They  pour  out  an 
increased  amount  of  fluid,  which  rapidly  evaporates  and  thus 
cools  off  the  surface  of  the  body.  For  this  reason  a  dry  atmos- 
phere of  high  temperature  can  be  borne  more  readily  than  an 
atmosphere  of  even  lower  temperature  laden  with  moisture.  In 
the  first  instance,  evaporation  of  moisture  readily  occurs ;  in  the 
latter,  evaporation  is  interfered  with  and  the  body  rapidly  be- 
comes overheated. 

KIDNEYS. 

Carbonic  acid,  salts,  urea,  and  water  are  discharged  in  the 
form  of  urine  from  the  kidneys  into  the  tubes  leading  from  the 
kidneys  to  the  bladder.  Urine  is  excreted  continuously  by  the 
kidneys,  and  trickles  drop  by  drop  into  the  bladder  until  a 
sufficient  quantity  has  accumulated  to  distend  that  organ  and 
cause  an  uneasy  sensation  to  be  felt  by  the  individual,  when  it 


MATERIAL  FOR  ADVANCED  FIRST-AID  STUDENTS.     137 

is  discharged  by  contraction  of  the  bladder.  In  a  normal  person 
about  42  ounces  is  excreted  daily,  but  the  amount  varies  in  dif- 
ferent individuals,  depending  upon  the  quantity  of  fluid  swal- 
lowed, upon  the  food,  upon  the  external  temperature,  and  upon 
the  amount  one  perspires. 

As  eliminators  of  water  the  kidneys  may  be  considered  as 
accessories  of  the  skin,  the  amount  of  water  they  excrete  de- 
pending upon  that  excreted  by  the  skin;  that  is,  the  less  the 
amount  lost  through  the  skin  the  more  will  be  excreted  by  the 
kidneys.  The  amount  of  solids  excreted,  however,  has  little  to 
do  with  perspiration,  being  dependent  entirely  on  the  waste 
going  on  in  the  body. 

MEDICATION. 

Although  the  Bureau  of  Mines  does  not  advocate  any  surgical 
or  medical  interference  by  first-aid  men,  nevertheless  miners  in 
their  homes  are  frequently  called  on  to  carry  out  instructions 
given  by  physicians,  and  often  the  miner  and  his  family  will  be 
obliged  to  take  the  initiative  until  the  doctor  arrives.  By  know- 
ing what  to  do  and  doing  it,  often  a  life  may  be  saved. 

The  administration  of  drugs,  outside  of  those  agents  em- 
ployed as  stimulants,  is  not  often  required  in  emergencies,  yet  a 
knowledge  of  this  subject  may  at  times  prove  of  the  greatest 
value  in  the  absence  of  a  physician  or  a  nurse. 

Medication  by  mouth  is  the  method  most  frequently  employed, 
and  is  applicable  when  rapid  effect  from  the  drug  is  not  of  prime 
importance ;  absorption  of  a  drug  from  the  stomach  takes  20  to 
30  minutes  before  the  effects  of  the  drug  are  felt.  If  rapid  action 
is  desired,  drugs  are  injected  by  means  of  a  hypodermic  syringe 
into  the  tissues  beneath  the  skin,  from  which  absorption  takes 


138     ADVANCED  FIEST-AID  INSTRUCTIONS  FOE  MINERS. 

place  within  four  or  five  minutes;  but  this  is  a  method  that 
should  be  employed  only  by  a  physician  or  nurse.  A  third 
method  of  administering  drugs  and  stimulants  is  by  the  rectum. 

MEDICATION    BY    MOUTH. 

When  drugs  are  administered  by  the  mouth,  they  are  pre- 
scribed in  the  form  of  solutions,  pills,  or  powders.  It  should  be 
remembered  that  a  drug  is  absorbed  more  rapidly  when  given  in 
solution  and  on  an  empty  stomach,  whereas  pills  and  powders  are 
absorbed  with  comparative  slowness  as  they  have  first  to  be 
dissolved  in  the  fluids  of  the  stomach  before  absorption  is  pos- 
sible. Likewise,  stimulants  given  hot  are  more  effective,  as  heat 
in  itself  is  somewhat  of  a  stimulant. 

The  quantity  of  a  drug  administered  at  a  given  time  will,  of 
course,  vary  according  to  the  particular  drug  used  and  the  pur- 
pose for  which  it  is  prescribed,  drops,  teaspoonfuls,  dessert- 
spoonfuls, and  tablespoonfuls  being  the  doses  employed. 
Roughly,  1  drop  means  a  minim,  a  teaspoonful  equals  60  drops  or 
1  dram,  a  dessertspoonful  equals  2  drams,  and  4  drams  is  a  half 
ounce.  When  minims,  drams,  etc.,  are  prescribed,  and  if  great 
accuracy  in  dosage  is  required,  as  with  more  powerful  remedies, 
the  doses  should  be  measured  by  means  of  a  medicine  dropper 
for  minims,  and  by  a  medicine  glass  for  drams.  The  glass  or 
dropper  used  should  always  be  perfectly  clean,  and  should  be 
carefully  washed  both  before  and  after  use.  When  any  drug  is 
administered,  great  care  should  be  taken  to  insure  that  the 
correct  drug  is  given.  To  make  doubly  sure,  the  label  should  be 
carefully  read  before  the  drug  is  measured  out  and  again  before 
it  is  given  to  the  patient. 


MATERIAL  FOR  ADVANCED  FIRST-AID  STUDENTS.     139 

RECTAL   MEDICATION. 

When  the  stomach  is  unable  to  retain  anything  or  if  the  patient 
is  in  such  a  condition  that  he  can  not  take  medicine  by  mouth, 
the  drug  may  be  introduced  into  the  rectum  by  means  of  an 
enema,  meaning  a  rectal  injection  of  liquid  medicine  or  food; 
or  in  a  suppository,  meaning  a  rectal  injection  of  a  solid.  It 
should  be  remembered,  however,  in  giving  drugs  in  this  way, 
that  although  the  absorptive  power  of  the  bowel  is  great,  drugs 
are  taken  into  the  circulation  slowly — in  about  three-quarters  of 
an  hour — and  if  a  rapid  effect  is  desired  this  method  should  not 
be  employed.  As  a  rule,  unless  the  drug  is  powerful,  the  dose  is 
twice  the  quantity  given  by  the  mouth. 

Enemata,  or  injections  of  fluids  into  the  bowels,  are  of  several 
kinds,  and  have  a  variety  of  uses.  The  doctor,  when  necessary, 
will  advise  the  kind  of  enema  needed.  Those  given  to  produce 
an  evacuation  of  the  bowels  are  known  as  purgative  enemata; 
another  class,  spoken  of  as  nutritive  enemata,  are  employed  to 
administer  food  or  drugs  by  the  rectum;  again,  in  the  treat- 
ment of  shock  or  hemorrhage,  large  quantities  of  salt  solutions 
are  frequently  injected  into  the  bowels,  and  these  are  known 
as  saline  enemata. 

The  simplest  apparatus  for  administering  an  enema  consists 
of  an  ordinary  fountain  syringe  and  hard-rubber  tip,  found  in 
nearly  all  households. 

To  give  the  enema,  a  sheet  folded  several  times,  or  a  single 
piece  of  rubber  sheeting,  should  be  placed  under  the  pa'tient  as 
a  protection  for  the  bed.  The  patient  is  then  turned  on  his  left 
side  with  his  knees  drawn  up.  The  fountain  syringe  should  be 
filled  with  the  solution  to  be  injected  and  the  air  should  be 


140     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

expelled  from  the  tubing  by  allowing  some  of  the  solution  to 
escape ;  the  nozzle  should  be  well  lubricated  with  olive  oil  or 
vaseline  and  should  be  gently  inserted  into  the  rectum  a  distance 
of  about  2  to  3  inches  while  the  patient  strains  slightly.  The 
syringe  should  then  be  raised  2  or  3  feet  above  the  patient  and 
its  contents  allowed  to  enter  the  bowel.  The  patient  is  apt  to 
complain  of  fullness  and  pain  in  the  rectum,  as  the  fluid  distends 
it,  but  if  the  flow  is  temporarily  stopped,  this  feeling  soon  passes 
off.  When  the  desired  quantity  has  been  introduced,  the  flow 
is  shut  off  by  pinching  the  tube  and  gently  withdrawing  the 
nozzle  from  the  rectum. 

When  an  enema  is  given  for  the  purpose  of  producing  an 
evacuation  of  the  bowels,  the  patient  should,  if  possible,  hold 
the  enema  for  5  or  10  minutes  before  using  the  bedpan.  If  an 
enema — as,  for  instance,  a  nutritive  or  a  saline  enema — is  to  be 
retained,  the  patient  should  lie  quietly  on  his  back  for  about 
half  an  hour  and  should  avoid  making  any  straining  efforts. 


PUBLICATIONS  OF  ESPECIAL  INTEREST  TO  MINERS. 

A  limited  supply  of  the  following  publications  of  the  Bureau 
of  Mines  is  temporarily  available  for  free  distribution.  Requests 
for  all  publications  can  not  be  granted,  and  to  insure  equitable 
distribution  applicants  are  requested  to  limit  their  selection  to 
publications  that  may  be  of  especial  interest  to  them.  Requests 
for  publications  should  be  addressed  to  the  Director,  Bureau  of 
Mines. 

Bulletin  17.  A  primer  on  explosives  for  coal  miners,  by  C.  E.  Munroe 
and  Clarence  Hall.  1011.  61  pp.,  10  pis.,  12  figs. 

Bulletin  62.  National  mine  rescue  and  first-aid  conference,  Pittsburgh, 
Pa.,  September  23-26,  1912,  by  H.  M.  Wilson.  1913.  74  pp. 

Bulletin  80.  A  primer  on  explosives  for  metal  miners  and  quarrymen, 
by  C.  E.  Munroe  and  Clarence  Hall.  1915.  125  pp.,  51  pis.,  17  figs. 

Bulletin  87.  Houses  for  mining  towns,  by  J.  H.  White.  1914.  64  pp., 
8  pis.,  9  figs. 

Technical  Paper  33.  Sanitation  at  mining  villages  in  the  Birmingham 
district,  Ala.,  by  D.  E.  Woodbridge.  1913.  27  pp.,  1  pi.,  9  figs. 

Technical  Paper  59.  Fires  in  Lake  Superior  iron  mines,  by  Edwin 
Higgins.  1913.  34  pp.,  2  pis. 

Technical  Paper  62.  Relative  effects  of  carbon  monoxide  on  small 
animals,  by  G.  A.  Burrell,  F.  M.  Seibert,  and  I.  W.  Robertson.  1914. 
23  pp. 

Technical  Paper  67.  Mine  signboards,  by  Edwin  Higgins  and  Edward 
Steidle.  1913.  15  pp.,  1  pi.,  4  figs. 

Technical  Paper  97.  Saving  fuel  in  heating  a  house,  by  L.  P.  Breckeu- 
ridge  and  S.  B.  Flagg.  1915.  35  pp.,  3  figs. 

141 


142     ADVANCED  FIRST-AID  INSTRUCTIONS  FOR  MINERS. 

Technical  Paper  111.  Safety  in  stone  quarrying,  by  Oliver  Bowles. 
1915.  48  pp.,  5  pis.,  4  figs. 

Technical  Paper  116.  Miners'  wash  and  change  houses,  by  J.  P.  White. 
1915.  27  pp.,  3  pis.,  3  figs. 

Miners'  Circular  5.  Electrical  accidents  in  mines,  their  causes  and 
prevention,  by  H.  H.  Clark,  W.  D.  Roberts,  L.  C.  Ilsey,  and  H.  F.  Ran- 
dolph. 1911.  10  pp.,  3  pis. 

Miners'  Circular  7.  Use  and  misuse  of  explosives  in  coal  mining,  by 
J.  J.  Rutledge,  with  a  preface  by  J.  A.  Holmes.  1913.  52  pp.,  8  figs. 

Miners'  Circular  9.  Accidents  from  falls  of  roof  and  coal,  by  G.  S. 
Rice.  1912.  16  pp. 

Miners'  Circular  10.  Mine  fires  and  how  to  fight  them,  by  J.  W.  Paul. 
1912.  14  pp. 

Miners'  Circular  11.  Accidents  from  mine  cars  and  locomotives,  by 
L.  M.  Jones.  1912.  16  pp. 

Miners'  Circular  12.  Use  and  care  of  miners'  safety  lamps,  by  J.  W. 
Paul.  1913.  16  pp.,  4  figs. 

Miners'  Circular  13.  Safety  in  tunneling,  by  D.  W.  Brunton  and  J.  A. 
Davis.  1913.  19  pp. 

Miners'  Circular  14.  Gases  found  in  coal  mines,  by  G.  A.  Burrell  and 
F.  M.  Seibert.  1913.  23  pp. 

Miners'  Circular  16.  Hints  on  coal-mine  ventilation,  by  J.  J.  Rut- 
ledge.  1914.  22  pp. 

Miners'  Circular  17.  Accidents  from  falls  of  rock  or  ore,  by  Edwin 
Higgins.  1914.  15  pp.,  8  figs. 

Miners'  Circular  18.  Notes  on  miners'  carbide  lamps,  by  J.  W.  Paul. 
1915.  11  pp. 

Miners'  Circular  19.  The  prevention  of  accidents  from  explosives  in 
metal  mining,  by  Edwin  Higgins.  1914.  16  pp.,  11  figs. 

Miners'  Circular  20.  How  a  miner  can  avoid  some  dangerous  diseases, 
by  A.  J.  Lanza  and  Joseph  H.  White.  1916.  26  pp.,  4  figs. 

Miners'  Circular  21.  What  a  miner  can  do  to  prevent  explosions  of 
gas  and  of  coal  dust,  by  G.  S.  Rice.  1915.  24  pp. 

Miners'  Circular  23.  Elementary  first  aid  for  the  miner,  by  W.  A. 
Lynott  and  Daniel  Harrington.  1916.  24  pp.,  19  figs. 


PUBLICATIONS  OF  ESPECIAL  INTEREST  TO  MINERS.  143 

PUBLICATIONS  THAT  MAY  BE  OBTAINED  ONLY  THROUGH 
THE  SUPERINTENDENT  OF  DOCUMENTS. 

The  editions  for  free  distribution  of  the  following  Bureau  of 
Mines  publications  are  exhausted,  but  copies  may  be  obtained 
by  purchase  from  the  Superintendent  of  Documents,  Government 
Printing  Office,  Washington,  D.  C.,  or  can  be  consulted  at  public 
libraries.  Prepayment  of  the  price  is  required  and  should  be 
made  in  cash  (exact  amount)  or  by  postal  or  express  money 
order  payable  to  the  Superintendent  of  Documents. 

The  Superintendent  of  Documents  is  an  official  of  the  Govern- 
ment Printing  Office  and  is  not  connected  with  the  Bureau  of 
Mines. 

Bulletin  44.  First  national  mine-safety  demonstration,  Pittsburgh,  Pa., 
October  30  and  31,  1911,  by  H.  M.  Wilson  and  A.  H.  Fay,  with  a  chapter 
on  the  explosion  at  the  experimental  mine,  by  G.  S.  Rice.  1912.  75  pp., 
8  pis.,  4  figs.  15  cents. 

Technical  Paper  24.  Mine  fires,  a  preliminary  study,  by  G.  S.  Rice. 
1912.  51  pp.,  1  fig.  5  cents. 

Technical  Paper  29.  Training  with  mine  rescue  breathing  apparatus, 
by  J.  W.  Paul.  1912.  16  pp. 

Technical  Paper  56.  Notes  on  the  prevention  of  gas  and  dust  explo- 
sions in  coal  mines,  by  G.  S.  Rice.  1913.  24  pp.  5  cents. 

Miners'  Circular  4.  The  use  and  care  of  mine  rescue  breathing  appa- 
ratus, by  J.  W.  Paul.  1911.  24  pp.,  5  figs.  5  cents. 

Miners'  Circular  15.  Rules  for  mine  rescue  and  first-aid  field  con- 
tests, by  J.  W.  Paul.  1913.  12  pp.  5  cents. 


INDEX. 


A. 

Page. 

Abdomen,  wound  of,  dressing  for 61 

figure  showing 61 

Air,  pure,  need  of 23 

Alcohol  poisoning,  symptoms  of 106 

treatment  for 106 

Alimentary   canal,   description   of 128-134 

American  Red  Cross,  cooperation  with 11 

Ammonia  water,  poisoning  by,  treatment  for 104 

Ankle,   dressings   for 67,  96 

figure  showing 68,96 

Apoplexy,  symptoms  of 106 

treatment  for 106 

Arm,  dressings  for 55,  56,  83,  84,  101 

figure  showing 56,84 

torn  from  body,  treatment  for 54,  55 

Armpit,  wound  of,  dressing  for 54,  55 

figure  showing 55 

Arteries,  figures  showing 20,  22 

points  on  which  to  apply  pressure 22,45 

B. 

Back,  dressings  for 61-63,99 

figure  showing 63,99 

Bandage  compress,  use  of 39 

Bandages  : 

abdomen 61 

ankle 67-69 

arm 55,  56 

armpit 54,  55 

back 61-63,  99 

chest 60 

collar  bone 81,82 

cravat 38,  39 

ear 53 

elbow 56 

eye 49-51 

face  or  chin 52 

145 


146  INDEX. 

Bandages — Continued.  Page. 

finger 59,  60 

foot 68 

forearm 56,  57 

forehead 48,  49 

groin 63,64 

hand 57-59 

heel __  67,  68 

hip 64,  65 

jaw 74 

knee 65,  66 

leg 66,  67 

neck  or  throat 52 

nose 51,  52 

placing  under  splints 97 

purposes  of 38 

scalp 47 

shoulder 53,  54,  61,  62,  75,  76 

temple 47,  48 

thigh 64,  65 

toe 69 

triangular 38 

varicose  veins 66 

wrist 56,  57 

See  also  Sling. 

Belladonna,  poisoning  by,  treatment  for 105 

Black  damp,  breathing  of,  dangers  in 30 

poisoning  from,  symptoms  of 30 

Bleeding.     See  Hemorrhage. 

Blood,  function  of 20 

Blood  vessels,  function  of 21 

See  also  Arteries. 

Body,  human,  structure  of 

Bruises,   causes  of 71 

symptoms  of 71 

treatment   for 72 

Bureau  of  Mines,  investigations  of 3 

mine  safety  stations  of 4 

See  also  Mine  safety  stations. 

work   of 3 

Burns,   dressings   for  : 

arm 101 

back 99 

figure    showing 99 

chest 100 

face 100 

hands   101 

head    100 

neck    100 

treatment  for 98,99 


INDEX.  147 

Page. 
Carbolic  acid,  poisoning  by,  symptoms  of 107 

treatment    for 

Carbon  monoxide,  poisoning  from,  dangers  of__. 

symptoms  of 31,  «|2 

treatment   for 

Caustic  potash,  poisoning  by,  treatment  for • 

Caustic  soda,  poisoning  by,  treatment  for 10* 

Chest,   dressings   for 60, 100 

figure    showing «" 

Chin,  dressing  for g£ 

figure    showing 

Chloroform,  poisoning  by,  treatment  for 

Collar  bone,  fractured,  dressing  for 

figure    showing 81,  »2 

D. 

Digestion,   process   of,    details    of 132-135 

Digestive  system,  description  and  function 24,  128-ldo 

See  also  Organs  named. 

Dislocations,  description  of £3 

elbow 76 

finger . 76 

hip,  dressing  for 77 

figure    showing 78 

jaw,  dressing  for <4 

figure    showing 74 

treatment   for 73,  74 

knee <6 

shoulder,  dressing  for 75,  7b 

figure    showing 7o 

See  Bandages,  Bandage  compress  ;  Splints. 

Drowning,   treatment  for 33 

Dressing  station,  surface,  equipment  for 7 

underground 10 

Drugs,  administering  of,  factors  governing 137-139 

E. 

Ear,  dressing  for 53 

figure  showing 53 

foreign  bodies  in,  removal  of 69,  70 

Elbuw,  dislocation  of 76 

dressings  for 56,  84,  85 

figure  showing 56,  85 

Electric  shock,  cause  of 28 

symptoms  of 28 

treatment  for 29 

51607°— 17 11 


148  INDEX. 

Page. 

Employees,  trained  in  first-aid  work,  need  of 12 

Enemas,  kinds  of 139 

method  of  administering 139,  140 

Epilepsy,  nature  of 25 

treatment  for 25,  26 

Esophagus,  description,  of 130 

function  of 133 

Ether,  poisoning  by,  treatment  for 105 

Excretory  system,  description  and  function 24,  135—137 

Eye,  wound  of,  dressing  for,  figure  showing 50 

treatment  for 49-51 

P. 
Face,  dressing  for 1 52,100 

figure  showing 52, 100 

Falling  sickness.     See  Epilepsy. 

Finger,  dislocation  of 76 

dressings  for 60,  88 

figure  showing 59 

Fire  damp,  dangers  from 30 

First  aid,  duties  in •_ 

limitations  of s 5 

First-aid  cabinet,  contents  of 7-10 

figure  showing 8 

cost  of 9,  10 

First-aid  certificates,  examinations  for 12 

First-aid  contests,  stretcher  drill  for 113-122 

figures    showing 113-117, 119,  121,  123 

First-aid  man,  instructions  to 14,  15,  16 

First-aid  training,  supervision  of 11 

Foot,  dressings  for 68,97 

figure  showing 68,  97 

Forearm,  dressing  for 57,  85,  86 

figure  showing 56,  86 

Forehead,  dressing  for 48,  49 

figure  showing 49 

Foreman,  duties  of 6 

Fractures,  compound,  treatment  for 98 

dressings  for  : 

arm 83,  84 

figure  showing 84 

collar  bone 81 

figure  showing 81,82 

elbow 84.  85 

finger 88 

foot 97 

forearm 85,  86 


INDEX.  149 

Fractures,  compound,  treatment  for — Continued. 

dressings  for — Continued.  -Page, 

hand 87 

jaw 80 

kneecap 95 

leg ; 96 

nose 80 

pelvis 91,  92 

rib 88,89 

shoulder   blade    83 

skull   80 

spine 89-91 

thigh     _, 93,94 

toe 97 

wrist 87 

kinds  of 78 

symptoms  of 78,  79 

treatment  for 79 

Freezing,   treatment   for 125 

Frost  bites,  treatment  for 1 125 

G. 

Gall  bladder,  description  of 132 

Gases,  mine,  poisoning  from 30 

Groin,   dressing  for 63 

figure  showing 64 

H. 

Hands,    dressing   for 57-59,  87,  101 

figure  showing 58,  59,  87 

Head,  dressing  for 100 

figure   showing   100 

Heart,  function  of 21 

Heat,  exhaustion  from,  symptoms  of 124,  125 

treatment   for 125 

Heel,  dressing  for 67 

figure   showing   68 

Hemorrhage  : 

abdomen 61 

ankle 67,  68 

arm 55,  56 

arm  torn  from  body 54,  55 

armpit    54 

arterial,    dangers   from 43,  44 

back    i 61,  62 

chest 60 

chin 52 

definition   of   43 


150  INDEX. 

Hemorrhage — Continued. 

ear    53 

elbow    56 

eye    49,50 

face    52 

finger    60 

foot 68 

forearm 57 

forehead 48,49 

hand __  57,58,59 

heel 67 

hip    64 

internal,  symptoms  of 46 

treatment   for   _.  47 

kinds  of 43 

knee    _.  —  65,  66 

leg 66,67 

methods  of  checking 44,  45 

neck    52 

nose    51,52 

scalp 47 

shoulder 53,  61 

temple 47,48 

thigh 64 

throat__  52 

toe 69 

varicose  veins 66 

wrist 57 

Hernia.     See  Rupture. 

Hip,  dressings  for . 64,  77 

figure  showing 65,78 

Hospital  room,  surface,  equipment  and  cost 10,11 

Hydrochloric  acid,  poisoning  by,  treatment  for 104 

I. 

Injured,  first-aid  treatment  of,  directions  for 13,  14 

importance  of 12 

transportation  of.  figures  showing 109,  110 

methods  of 108-110 

precautions  in 112 

Intestines,  description  of 131,  13: 

process  of  digestion  in 134,  135 

J. 

Jaw,  dislocation  of,  dressing  for 73,  74 

figure  showing 74 

reduction  of 73 

fracture  of,  treatment  for 80 

Joints,  definition  of 19 


INDEX.  151 

K.  Page. 

Kidneys,  function  of 136,  137 

Knee,   dislocation   of 76 

dressing  for 65,  66 

figure  showing 66 

Kneecap,  fracture  of,  dressing  for 95 

figure    showing 95 

Knot,  reef,  figure  showing 43 

method  of  tying 42,43 

L. 

Larynx,  function  of 22 

Laudanum  poisoning,  treatment  for 105 

Leg,  dressing  for 66,67,96 

figure  showing 67,96 

Liver,  description  of 132 

Lungs,  definition  and  function 23 

removal  of  waste  by 134 

Lye,  poisoning  by,  treatment  for 104 

M. 

Medication  by  mouth,  factors  governing 137,  138 

rectal,  factors  governing 139 

Mine  owners,  duties  of 6 

Mine  safety  stations,  location  of 4 

purpose  of 4 

work  at 4 

Morphine  poisoning,  treatment  for 105 

Mouth,  description  of 128-130 

medication  by,  factors  governing 138 

Muscles,  purpose  of 19 

surface,  figure  showing 19 

Mustard  plaster,  preparation  of 126 

poultice,  preparation  of 126 

N. 

Neck,  dressings  for 52,  100 

figure  showing 100 

Nervous  system,  description  and  function 24,  25 

Nitric  acid,  poisoning,  treatment  for 104 

Nose,  dressings   for 51,  52,  80 

figure  showing 51 

foreign  bodies  in,  removal  of 70 

function  of 22 


152  INDEX. 

O.  Page. 

Opium  poisoning,  treatment  for 105 

Organization  of  first  aid,  committees  in 6,  7 

factors  in  success  of 5,  6 

membership   in 6 

purpose  of 5 

P. 

Pancreas,    description    of 132 

Paregoric  poisoning,  treatment  for 105 

Pelvis,  fracture  of,  dressing  for 91,  92 

figure    showing 92 

Perspiration,  excretion  of,  factors  governing 135,  136 

Plasters.     See  Mustard  plaster. 

Poisoning,  alcoholic,  symptoms  of 106 

treatment  for 106 

carbolic  acid,  symptoms  of 107 

treatment  for 107 

corrosive,  kinds  of 103 

symptoms  of 103, 104 

treatment  for 104 

irritant,  list  of 104' 

symptoms  of 104 

treatment  for 105 

nerve,  classes  of 105 

treatment  for 105 

Potash,  poisoning  from,  treatment  for 104 

Poultice.    See  Mustard  poultice. 

R. 

Respiration,  artificial,  factors  governing 36 

method  of 33-35 

figures  showing 34,  35 

definition    of 22 

description  of 23 

Rib,  dressing  for 88,89 

figure   showing 88 

Rupture,   cause  of 

symptoms  of 101 

treatment  for 102 

S. 

Saliva,    function    of 130, 133 

Scalds.    See  Burns. 

Scalp,  dressing  for 47 

figure  showing 47 


INDEX.  153 

Page. 
Schaefer  method  of  artificial  respiration 33-35 

figures    showing 34,  35 

Shock,  description  of ;_          26 

treatment  for 26,  27 

See  also  Electric  shock. 

Shoulder,    dressings    for 53,  54,  61,  75,  76 

figure   showing 54,  62,  75 

Shoulder  blade,  fracture  of,  dressing  for 83 

Skeleton,  figure  showing 18 

structure  of 17-19 

Skin,  definition  of 20 

function  of 135,136 

Skull,  fracture  of,  dressing  for 80 

symptoms    of 79 

Sleeping  powders,  poisoning  by,  treatment  for 105 

Sling,  arm 39 

cravat 39 

Snake  bites,  treatment  for 125 

Soda,  poisoning  by,  treatment  for 104 

Spine,  fracture  of,   dressings  for 89-91 

figure  showing 90,  91 

Splints,  first-aid,  figure  showing 121 

improvised,  making  of 42 

placing  bandages  under 97 

uses  of 41 

Sprains,   causes  of 72 

treatment  for 72 

Stimulants,  administering  of,  factors  governing 137-139 

Stomach,   description   of : 130,  131 

foreign   bodies  in 71 

process  of  digestion  in 133, 135 

Strains,  causes  of 72 

treatment  for 72 

Stretcher,  Army,  figure  showing 121 

improvised,   method   of  making 111 

types  of 111,112 

Stretcher  drill,  description  of 113-122 

diagram  of 123 

figures  showing 113-117, 119,  121,  123 

Strychnine,  poisoning  by,  treatment  for 105 

Suffocation,  symptoms  of 29,  30 

Sulphuric  acid,  poisoning  by,  treatment  for 104 

Sunstroke,  symptoms  of 124 

treatment  for 124 

Superintendent,   mine,  duties  of I 6 

Surgeon,   mine,   duties  of 6 

Sweat  glands,  function  of „ _I 136 


154  INDEX. 

T.  Page. 

Teeth,  function  of _________________________________________       133 

structure  of __________________________________________ 129-130 

Temple,  dressing  for _______________________________________ 47,  48 

figure  showing ____________________________________  48 

Tendons,  definition  of ______________________________________         20 

Thigh,   dressings   for _________________________________ 64,65,03,94 

figure  showing ------------------------------------ 65,  94 

Throat,  description  of ______________________________________         22 

foreign  bodies  in,  removal  of ____________________________         70 

wound  of,  dressing  for _________________________________  52 

Toe,   dressings   for _________________________________________ 69,  97 

figure  showing __________________________________ __  69,97 

Tongue,   description   of _____________________________________       128 

Tourniquet,  description  and  uses ____________________________ 40,  41 

figure  showing _________________________________________ 40,  41 

Transportation  of  injured,  methods  of _____________________ 108-110 

figures  showing _____________________________ • _____ 109,  110 

precautions  in ________________________________________        112 

See  also  Stretcher. 

Turpentine  stupe,  preparation  of ____________________________       127 

V. 

Varicose  veins,  dressing  for _________________________________         66 

Veins,  figure  showing ------------------- , ___________________         20 

W. 

White  damp.     See  Carbon  monoxide. 

Windpipe,  foreign  bodies  in,  removal  of ______________________         70 

Wound,  definition  of _______________________________________         45 

dressings  for.     See  Bandages. 

general  treatment  for __________________________________ 45,  46 

infection  of,  precautions  against ________________________         46 

kinds  of _________ _____________________________________         45 

Wrist,   dressing  for ________________________________________ 57,  87 

figure  showing ------------------------------------         57 


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